In 1998-2002 there were 93 patients, who started hemodialysis in Hemodialysis unit at Kaunas University of Medicine Hospital. According to start of hemodialysis all patients were divided into two groups: first group--patients (n=58, 62.3% ), who started hemodialysis through central venous catheter; second group--patients (n=35, 37.7%), who started hemodialysis on time through matured arterio-venous fistula. Comparing these groups, we noticed, that in the first group first hospitalization was longer, anemia was more severe and renal failure was more prominent, than in the second group. We analyzed the third group of patients (n=32), already on hemodialysis, which were hospitalized because of disfunction of arterio-venous fistula. The main cause of disfunction of arterio-venous access were thrombosis and low blood flow. In urgent hemodialysis, punction of vena jugularis predominated vena subclavia punctions. More infection complications were noticed, in cases of vena subclavia punctions.