The cross-sectional study of the patients receiving hemodialysis (HD) treatment in the dialysis departments in Minsk at the beginning of the year 2017 was made. The aim of the study was to define the main cause of the end stage renal disease (ESRD) among HD patients in the dialysis departments in Minsk. According to the inclusion and exclusion criteria, 289 patients were selected for further analysis. The median of the age was 57 (45; 66) years, for men it was 174 (60.2 %) years. The median of therapy duration was 26 (8; 66) months. The main cause of the end stage renal disease was chronic glomerulonephritis in 35.3 % of patients, the second was diabetes mellitus in 15.9 % of patients, and the third was the polycystic disease in 13.5 % of patients. Kidney damage in the frame of ANCA-vasculitis was revealed in 4 (1.4 %) patients, which is less than in Eastern European Centers where systemic vasculitis is the cause of ESRD in 6.7 % of cases. Histological verification of the diagnosis was conducted in 25 (8.7 %) patients while the most frequent diagnosis was IgA-nephropathy tht was defined in 44 % of biopsied persons. The results of our analysis point to an insufficient rate of histopathology that proved the diagnosis among of the HD patients in Minsk. It does not allow us to conduct a complete differential diagnosis between kidney damage due to the primary diffuse kidney disease or arterial hypertension, diabetes mellitus and systemic vacuities.