Background: Malnutrition and loss of appetite represent a serious problem in children with chronic renal failure. Ghrelin is a newly described hormone involved in control of growth hormone secretion, stimulation of food intake, and regulation of energy balance.Aim of the work : The aim of this study was to compare the plasma ghrelin in different groups including chronic renal failure (CRF) patients on regular hemodialysis, chronic kidney disease(CKD) patients on conservative treatment and renal transplantation patients.Methods: Plasma ghrelin levels were compared between 30 CRF patients on heamodialysis,30 CKD patients on conservative treatment& 20 transplant subjects with measuring body mass index (BMI) .Results: Plasma ghrelin levels were significantly higher in hemodialysis patients and CKD on conservative treatment (2.8+0.25 & 2.8+0.3 respectively ) compared to transplant (2.1+0.2) (p-value <0.001),and was negatively related to BMI.Conclusion: Plasma ghrelin level is considered as a surrogate marker of malnutrition in CKD.