Clinical significance of insulin resistance in patients with chronic renal failure treated with dialysis has not been fully elucidated and requires further research. The available data indicate that long-term dialysis therapy promotes the development of insulin resistance. Furthermore, it has been proven that insulin resistance in this patient group is a strong independent predictor of mortality from cardiovascular causes. Insulin resistance as a potential modifiable cardiovascular risk factor should be considered as a novel therapeutic target in patients undergoing both hemo dialysis and peritoneal dialysis.