All patients with chronic kidney disease on regular hemodialysis will be enrolled.
\- Study location: The patients will be recruited from pediatric nephrology department, Cairo University Children's Hospital and Beni Suef University.
History taking including the age, sex, primary cause of CKD, onset of hemodialysis, medications including erythropoietin dose, frequency, and duration, oral or intravenous iron therapy, and frequency of blood transfusion.
Clinical examination focusing on pallor, blood pressure, and anthropometric measurements and their percentile.
Investigations including hemoglobin level at the start of the study and every month during the study period, serum ferritin, alanine aminotransferase, total oxidative stress (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) at the start and after 3 months of the onset of the study.
Patients will receive N-acetyl cysteine (10 mg/kg/day, orally). The duration of the study will 3 months.
