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Cardiovascular diseases are the most common causes of death among chronic hemodialysis patients. In this book, we will focus on cardiovascular disease in pediatric chronic hemodialysis and their Pathophysiology. We also identified the risk factors for cardiovascular vascular disease in hemodialysis patients for the sake of prevention Controlling hypertension,anemia, dyslipidemia and volume overload help in decreasing the risk of cardiovascular disease in addition to that hemodialysis prescription including(frequency and duration) should be manipulated also to achieve adequate dialysis and decrease the risk of cardiovascular diseases.