Hip fractures are an important problem for end-stage renal disease (ESRD) patients treated with dialysis. The incidence of hip fractures in the dialysis population is approximately four times that of the general population. Even more concerning is the associated 1 year mortality, which is twice that of other dialysis patients. Management of this problem is complicated by the heterogeneous nature of renal osteodystrophy and the inadequate methods of diagnosis currently available. Fall prevention has been shown to reduce the incidence of hip fracture and associated decline in functional ability in the general population. Because falls occur frequently in the dialysis population, simple fall prevention may be one important way of protecting dialysis patients from the morbidity and mortality of hip fracture.