The aim of the present study is to clarify relevant factors concerning the short-term outcome of elderly patients beginning dialysis. One hundred nineteen patients aged 60 years and over who had newly started dialysis at our hospital were studied. The male/female ratio was 70:49. The age was 74 +/- 7 years (mean +/- standard deviation). In all patients, the timing of referral to a nephrologist (early/late), the urgency of the initiation of dialysis (non-urgent/urgent), the cause of renal failure (nondiabetes/diabetes), serum albumin concentration, comorbid conditions (cerebrovascular disease, ischemic heart disease, etc.), ambulation, cognitive function, and the outcome (relief/death) were surveyed. Twelve patients did not obtain relief and finally died. The influence of the timing of referral on the urgency of the initiation of dialysis was studied. Furthermore the influence of the urgency of the initiation of dialysis on the outcome was studied. The chi 2 test was used for statistical comparisons. The need for urgent dialysis was less among early referral cases as compared with late referral cases (p < 0.0001). The incidence of death was more frequent in urgent dialysis than in non-urgent dialysis (p = 0.016). Multivariate logistic regression analysis was performed using background factors as explanatory variables and the outcome as a dependent variable. Statistically significant factors were the urgency of the initiation (p = 0.040), serum albumin concentration (p = 0.022), and cerebrovascular disease (p = 0.002). The most common cause of death was severe infectious diseases (pneumonia, sepsis). It was speculated that background factors associated with the outcome could contribute to the onset and the progression of infectious diseases.