Abstract
INTRODUCTION: Anemia is a common symptom of end stage renal disease in children and adolescents. Anemia is one factor for patients with end stage renal disease that have an effect on quality of life. Therefore, the purpose of this study was to examine the correlation between the hemoglobin level and quality of life and fatigue level for children and adolescent in Jordan. 
 
 MATERIALS & METHODS: A cross-sectional correlational design was used. A total of 121 children and adolescences were recruited from hemodialysis units at seven hospitals of three cities in Jordan. Data collected through the 34-item Pediatric Quality of Life Inventory 3.0 End-Stage Renal Disease (PedsQL 3.0 ESRD questionnaire.
 
 RESULTS: The results of this study demonstrated that 38 (31.4%) school-age children their age ranged from 6 to 12 years old, while adolescents (13-20) years old 83 (68.6%), and 67 (55.4) of them were female. Children and adolescents with ESRD reported low mean hemoglobin level over 7 months below 11.1g/dlSD (1.9). A significantly negative correlation between the PedsQL total scores with mean hemoglobin levels p<0.05 was reported, and positive correlation with fatigue sub-score p<0.05. 
 
 CONCLUSIONS: It is essential for nurses and patients to recognize the relationship between anemia and low quality of life and high fatigue level for end stage renal disease children and adolescent patients. Finding of current study are facilitating to design especial program for improve the nutritional and health status for those ESRD patients.
Highlights
Anemia is a common symptom of end stage renal disease in children and adolescents
Children and adolescents with ESRD reported low mean hemoglobin level over 7 months below 11.1g/dlSD (1.9)
A significantly negative correlation between the PedsQL total scores with mean hemoglobin levels p
Summary
Anemia is one factor for patients with end stage renal disease that have an effect on quality of life. Low hemoglobin below normal level to age is considered anemia (Hockenberry, Rodgers, & Wilson, 2017). This could be happen related to many factors as renal disease that leads to erythropoietin deficiency; other causative factors include blood loss, infection or inflammation , or nutritional deficiency such as some mineral that contribute production of hemoglobin as iron, folate, or/and vitamin B12 (Koshy & Geary, 2006; Kliger et al, 2013).
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