This book will give you more understanding of renal failure in pediatric acute kidney injury and chronic kidney diseases causes, risk factors, complications, and management. This book will give you more information about principle of hemodialysis in children challenges and complications .in this book you will find exact details about challenges of hemodynamics and fluid status management in pediatric age group, new radiological techniques and devices that can help better management of children who needs hemodialysis. Here we will discuss in details role of chest ultrasound in pediatric nephrology B lines and its application to evaluate hemodynamics and fluid status and early diagnosis of pulmonary congestion, pneumonia and pleural effusion using bed side ultrasound with non-invasive safe easy learned tool that can be applied by nephrologist after adequate training. We will also give a hint on other diagnostic values of chest ultrasound in critically ill patients and in diagnosis and management of COVID 19. In the book we will discuss role of radiological measurement of inferior vena cava diameter and collapsibility index in evaluation of systemic congestion and fluid overload in children on hemodialysis for better management and accurate dry weight assessment that can decrease complications including hypertension, hypotension, and dialysis tolerability. In this book we will discuss role of chest bio impedance in fluid status management in children on hemodialysis using ICON electrical cardiometry device by measuring thoracic fluid Content that can help also in evaluation of cardiac function, cardiac output, ejection fraction and cardiac index. This device is a small bedside device with electrical electrodes that can be applied to critically ill or stable patients by bed side evaluation of all cardiac functions.