This study included forty patients with end stage renal diseases, twenty-five patients on conservative management and fifteen patients on regular hemodialysis. These patients were subjected to clinical assessment, renal assessment using creatinine clearance and DTPA dynamic isotopic scan and bone assessment using conventional X-ray on wrist and digits as well as MDP bone Scan. The results showed that bony Pains and stunted growth were the most evident bony manifestations. Serum Parathrormone was elevated in nearly one half of the Patients. Rediological assessment revealed that the use of MDP bone scan is more sensitive and earlier Predictor for bone changes associated with chronic renal diseases.