114DOES TRAMADOL ABUSE WORSEN COMPLICATIONS AMONG URAEMICSTramadol abuse is widely increasing phenomena especially among young adults. In this study, we studied the prevalence of tramadol abuse among uremics (< 40 years old) on hemodailysis replacement therapy then we evaluated its effect on common uremia and hemodilaysis complications; anemia, hypertension and occurrence cramps during sessions. Tramadol abusers had shown significantly lower levels of hemoglobin, hematocrit and reticulocytes production index relative to uremics nonabusers. In addition, uremics on tramadol had showed higher incidence of systolic and diastolic hypertension. Moreover, higher incidence of cramps on hemodialysis sessions was shown in tramadol abusers.may_s65@hotmail.comResearch542015Tramadol, Terminal clinical manifestation,HyperparathyroidismEkramy Elmorsy, Mostafa Abdelsalam,Ahmed Abd El-Whab,Amal Misbah Elsaid,Maysaa El Sayed Zaki,Nahla AnberDepartment of Forensic Medicine and Clinical Toxicology Mansoura University, Egypt., Department of Internal medicine, Mansoura Nephrology and Dialysis Unit Mansoura University, Egypt., Department of Internal medicine, Mansoura Nephrology and Dialysis Unit Mansoura University, Egypt.,Faculty of Medicine, Mansoura University, Egypt and Clinical Pathology, (Mansoura Chest Hospital ) Minsitry of Health, Egypt., Clinical Pathology Department, Mansoura faculty of Medicine, Egypt, Emergency hospital, Mansoura faculty of Medicin, Clinical Pathology Department, Mansoura faculty of Medicine, Egypt, Emergency hospital, Mansoura faculty of Medicin