الفهرس 
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Abstract
Background: Renal diseases are the commonest cause of secondary hypertension and hypertension is an important presenting feature of renal diseases. Approximately 60 % to 80 % of secondary hypertension in childhood is caused by renal parenchymal disease . Aim of work: The aim of this study is to evaluate the plasma level of endothelin-1 and nitric oxide in children with different renal disorders. Methods: This study was carried out on 53 patients with different renal parenchymal diseases. In addition to a control group consisted of 15 healthy children of matched age and sex. These patients were classified into 3 groups: group I: primary nephrotic syndrome, group II: acute poststreptococcal glomerulonephritis and group III: end stage renal disease.in addition to a control group of 15 healthy children of matched age and sex. Results: -Nephrotic patients showed significantly lower ET-1 level in normotensive patients than controls without significant difference between hypertensives and normotensives or hypertensives and controls. NO level was significantly higher in both hypertensive and normotensive nephrotic patients than controls without significant difference between hypertensives and normotensives. - In patients with acute poststreptococcal glomerulonephritis, both hypertensive and normotensive patients had a significantly lower ET-1 level than controls without significant difference between hypertensives and normotensives. NO was significantly higher in hypertensive and normotensive patients than controls without significant difference between both patient subgroups. - End stage renal disease patients had no significant difference from controls regarding ET-1 level but both hypertensive and normotensive patients had a significant higher NO level than controls without significant difference between patients subgroups. - NO/ET-1 ratio was significantly higher in normotensive patients with APSGN than hypertensives. - No significant correlation was found between NO and ET-1 and other clinical or laboratory parameters. Conclusion: -Normal or lower ET-1 level in patients with PNS, APSGN or CRF that may suggest lack of natriuresis and diuresis as a pathogenic mechanism for hypertension or that the tissue level is more important than the circulatory level. - The lack of difference in ET-1 between hypertensives and normotensives in various groups may denote difference in vascular sensitivity to ET-1 in these patients. - NO level was significantly higher in all patient groups than controls which may have a protective role against hypertension in these patients. - The balance between NO and ET-1 and other vasoactive substances determines the overall vascular tone and consequently blood pressure.