Growth retardation is a common problem in children with chronic renal failure and end-stage renal disease. This study included 50 patients. They were divided into two groups: the conservative group with the Glomerular Filtration Rate (GFR)<40ml/min/1.73m2 and the end-stage renal disease group with the GFR< 10ml/min/1.73m2. The conservative group included 18 children having chronic renal failure on conservative treatment selected from the outpatient clinic of the Pediatric Nephrology Department of Cairo University Pediatric Hospital. The end-stage renal disease group included 32 children on regular hemodialysis, selected from the hemodialysis unit of the Center of Pediatric Nephrology and transplantation, Cairo University. In addition to 20 normal children to serve as a control group selected from the outpatient clinic of the Pediatric Surgery Department of Cairo University Pediatric Hospital. Growth retardation was detected in the study group in comparison to the control group. All contributing factors were searched for, in addition to determination of Human Growth Hormone (HGH) and Insulin-like Growth Factor-1 (IGF-1) levels. A hormonal resistance rather than deficiency was noticed in these children. This clarifies the value of giving these children exogenous Growth Hormone to overcome the peripheral resistance.