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Most of the young people in whom we start dialysis live a little longer compared to the older people. It is being proven beyond doubt. Young people can have 80% of their normal life and prolong their life on dialyisis. But definitely old people cannot prolong because of so many underlying morbidity. Basic problem is the potassium, which is to be controlled in the diet, probably some people who are unable to control they tend to have a problem and sometimes we may have to admit them frequently to take care of this and the frequency of the dialysis have to be increased. The most commonest cause of death on dialysis is cardiovascular death and more than 50% of patients die due to cardiovascular death and also an infection and sometimes we have to withdraw dialysis at some situations where we cannot perform further. The long term effects are some where they can have an uncontrolled hypertension on dialysis where 10% of the patient do not follow the diet or take proper dialysis.other conditions are metabolic conditions where they can have IPTH i.e. parathyroid hormone can get elevated and high phosphorous on dialysis which is present in the diet definitely has to be removed by a dialysis. Sometimes nocturnal dialysis which is done at the night time scan help in these situations. They also have hyperlipidaemia once their appetite improves.