Chronic renal failure (CRF) is characterized by impaired renal function, which is progressive and irreversible. This study was carried out to investigate the status and causes of CRF in HD patients in Fars Province, Iran. In this cross-sectional study, HD patients were evaluated in Fars province. Information for demographic characteristics, and medical history were obtained by using a questionnaire administered by trained staff. 633 cases including 371 male and 262 female were studied. The mean KT/V was 1 0.4. KT/V > 1.2 was achieved in only 32.1% (203/633) of all patients. The mean BMI was 24 +/- 4.5. The most common causes of CRF were hypertension (30.5%) and diabetes mellitus (30.1%). In conclusion most common causes of CRF in this region were hypertension and diabetes mellitus. Better management of hypertension and diabetes could prevent patients from ending up with end stage renal disease.