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Background: Objective: To provide information on the challenges of haemodialysis in a resource limited setting in South-Western Nigeria.

Methods: This is a 5 year audit of all haemodialysis sessions carried out at the renal unit of the Ladoke Akintola University Teaching Hospital (LAUTECH), Osogbo, Nigeria.

Results: A total of 225 patients were offered haemodialysis (HD) during this period with age range of 10 to 85 years (mean age of 49 years±16.25). There were 155 males and 70 females (male to female ratio of 2.2: 1). Chronic kidney failure accounted for 180 (80%) of the cases while acute kidney injury (AKI) constituted 45 (20%) of the cases offered haemodialysis. The sessions of HD in both cases ranged from 1 to 27 with an average of 3 sessions. Hypotension is still the commonest intradialytic complication at our setting while diabetic nephropathy is rapidly emerging as a major cause of end stage renal disease at our setting requiring HD. As seen in other parts of the tropics sepsis, nephrotoxins