Recent studies showed that Kt/Vurea in dialysis cannot represent correctly the removal of other solutes and fluid, indicating that this parameter alone should not be used as the sole indicator of dialysis adequacy. We aimed to identify whether Erythrocyte glutathione transferase as biomarker for haemodialysis adequacy in children with End Stage Renal Disease (ESRD) on regular haemodialysis. This study was conducted on 50 persons divided into two groups. Group A: 2 5ESRD patients receiving conventional hemodialysis atBENHA university hospitals hemodialysis units. GroupB(Control): 25 aPP.arently healthy subjects. All patients was subjected to Erythrocyte glutathione transferase with ELISA technique. Our study showed that Erythrocyte glutathione transferase cut off value in HD patients 39,1 ng/dl. its sensitivity was 81% , specificity was 88,9 % and accuracy was 84%.In our study The post HD analysis of E-GST level showed significant difference between control and conventional HD (p-value 0.001&0.001) respectively. This means that E-GST has the same power to express dialysis adequacy like URR, Kt/V Urea, Also it is mirror of URR & Kt/V. Erythrocyte glutathione transferase is highly sensitive & specific marker in hemodialysis patients and its level can express hemodialysis adequacy and toxins removal in several sessions by different hemodialysis modalities.