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Abstract ESRD, is the end result of many etiological factors that can be primary in the kidney or secondary to systemic or urinary diseases. This study was focused on causes of ESRD in HD patients in all renl units in Assiut governorate and include 1109 patients, to detect cases without apparent cause of ESRD, and also finding of risk factors that known to be a direct or indirect injurious factor to the kidney. So, we found that the leading causes of ESRD were respectively: • Unknown causes: 25%. • Hypertensive nephropathy:21.4% • Diabetic nephropathy:14.9% • :Obstructive uropathy: 11% • chronic pyelonephritis: 8.9% • chronic glomerulonephritis:8% • Analgesic nephropathy:3% • Systemic lupus erythematosus: 2.2% • Toxemia of pregnancy:2% • Gout nephropathy:0.9% • APKD:0.7% As regard, the mean age of ESRD, it was 44.5 years old, with standard deviation ±12.3 years. Also we found that ESRD is more common in male (65.7%), than in females (34.3%) |