Background: Chronic kidney disease is a worldwide public health problem and is now recognized as a common condition that is associated with an increased risk of cardiovascular disease and chronic renal failure (Bash LD et al.,2009) .Chronic kidney disease define as either kidney damage or a decrease kidney glomerular filteration rate (G F R) of less than60 ml / min / 1.73 m2for three or more months (Choi AI et al., 2009) , Whatever the underlying etiology, the destruction of renal mass with irreversible sclerosis and loss of nephrons leads to a progressive decline in (G F R) . Methods: Immunological measurements of monocyte sub population (CD Markers) CD4 and CD56 for 48 Patients were divided to 4 groups. Tow control groups,One of 12 healthy adults and other one for 12 healthy Children. Tow Patients group, one of 12 Egyptian adults of high serum creatnine concentration under renal dialysis and last group of 12Egyptian children of high serum creatinine concentration under renal dialysis. In this work we investigate CD 4 and CD56 in Monocyte sub population in Egyptian adults and children at end stage renal disease under renal dialysis to evaluate the immune response. Results: In this study we found that CD4 and CD56 is decreased in most Egyptian adults and children of high serum creatinine concentration under renal dialysis compared to healthy control groups where (P < 0.05). Conclusion: Altered immune function in patients with renal failure results in both susceptibility to infection and increased inflammatory response. Our study reached that Monocyte sub population (CD Markers) CD4 and CD56in Egyptian children and adults are decreased in most tested patients with chronic renal failure (at End Stage Renal Disease) under renal dialysis.