Background: End stage renal disease (ESRD) could be developed with or without the risk factors. However, the more risk factors presented the greater likelihood of developing ESRD. The aim of the present study was to evaluate the effect of teaching guidelines on self-efficacy for patients with end stage renal disease. Research design used was Quasi experimental research design utilized in this study. The study was carried out at Urology and Nephrology Center of Mansoura University. A purposive sample including 80 Egyptian patients with ESRD on Hemodialysis therapy. Two tools were used in data collection; Tool I a structured Questionnaire tool, Tool II Chronic Kidney Disease- Self Efficacy (CKD- SE) Scale. The Result of the study reveals that there were high statistical significant differences in study subjects' Mean Scores of four domains of CKD-SE scale between Pre and Post implementation of the teaching guidelines. Conclusion: It can be concluded that patients with ESRD treated with Hemodialysis tended to have higher scores (better SE) post implementation of teaching guidelines. Recommendations: Replication and expanded studies are needed for hemodialysis patients. Future studies should try to incorporate prospective data collection, long term follow-up and validated disease specific SE instruments