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Abstract Chronic renal failure (CRF) is a clinical syndrome that results in the permanent loss of renal function due to the progressive loss of nephrons.It is also defined as the presence of markers of kidney damage (abnormalities in blood, urine, or imaging tests ) for ≥3 months or a glomerular filtration rate (GFR) <60 mL/minute/1.73 m2 for ≥3 months,with or without other signs of kidney damage. The Kidney Disease Outcomes Quality Initiative designates 5 stages of CKD, with stage 5 being ESRD, the point at which patients’ loss of kidney function precipitates a need for dialysis or kidney transplant .Uremia-related immune dysfunction is a complex pathological condition in which chronic activation of immune system and immune suppression coexist. Understanding the mechanisms behind the immune dysfunction that is peculiar to ESRD represent an important target for intervention aiming to reduce morbidity and mortality in these childrens .Deficiency of trace elements such as zinc has been described in patients with CRF undergoing HD. Causes of this deficiency may be related to a low dietary intake of these trace elements, a decrease of their intestinal absorption, and their loss to the dialysate(4), and this increase susceptibility to oxidative stress, inflammation, and reduced immune regulation of T lymphocytes . |