Background: Patients with chronic kidney disease (CKD) are at risk for anemia as a result of a variety of factors. Blood ferritin levels are an indicator of iron, while blood transferrin receptor (sTfR) levels are an indicator of how much iron is available for cells to use. Objective: It was the goal of this work to determine the diagnostic value of serum soluble transferrin receptor (sTfR) in children undergoing regular hemodialysis in Pediatric Nephrology Unit in Zagazig University. Patients and Methods: Our study was applied on 44 children admitted to Pediatric Nephrology Unit at the Pediatric Department in Zagazig University Children Hospital for hemodialysis, during the period from January 2019 to July 2019. Iron profile (serum Iron, ferritin, total iron-binding capacity (TIBC) and serum transferrin) as well as transferrin saturation-sTfRs TfR/log ferritin index was done to all children. Results: Statistically significant positive association between iron, ferritin, total saturation of transferrin (TSAT) and hemoglobin (Hb) as well as statistically significant negative correlation between TSAT, iron, ferritin and sTfR were found. Anemia of chronic disease (ACD) patients' dialysis time was much longer than that of (Iron deficiency anemia) IDA patients, while hypertension was significantly higher in IDA patients than in ACD patients. The optimal cutoff value for sTfR was (1.75) with a sensitivity of 82% and a specificity of 73.6 %. Conclusion: STfR is a valuable metric for distinguishing between ACD and IDA, as well as between ACD in patients who get regular hemodialysis. In HD patients, sTfR can be utilized to check iron levels.