Background: Chronic kidney disease is a progressive deterioration of kidney functions which associated with metabolism, fluids and electrolytes disturbances. In addition, impairment of growth and development. Purpose: it was to examine the effect of nutritional guidance on parents’ awareness and nutritional status of children undergoing hemodialysis. A Quasi-experimental design was utilized. Setting: Pediatric Hemodialysis Unit, EL Menoufia University Hospital in Shebein El-kom city. Sample: purposive sample of 30 children and their parents were included in the study. Instruments for data collection:three instruments were used, instrument one; A structured interview questionnaire developed by the investigators to collect data regarding the study consists of 2 parts: 1st part: socio demographic data of children, 2nd part: Parents' knowledge toward chronic kidney disease; instrument two was anthropometric measures and 24 hours dietary recall; instrument three was a structured interview questionnaire to assess parents awareness about nutritional requirements of their children. The results of this study showed that, more than half of children were under weight, around two thirds of children achieved normal weight on follow up test. The study concluded that implementation of nutritional guidance improved parents’ awareness about adequate nutrition for their children and improved nutritional status of children undergoing hemodialysis on post and follow up tests than on pretest. Therefore, it was recommended that regular nutritional assessment of children should be maintained throughout their hemodialysis period and nurses should provide nutritional education for their mothers.