Hypertension is often observed in dialysis patients and renal transplant recipients and is a very important risk factor for cardiovascular morbidity and mortality. Despite this high prevalence, the treatment of hypertension in these populations is poorly characterized. This article describes the current state of knowledge in treatment of hypertension in patients on renal replacement therapy. It is not appropriate, to limit the choice of drug to a single class of agents because people usually have other medical problems that affect this decision.