Objective: The present study was a retrospective cross-sectional analytical study. Methods: This study was conducted on 301 hemodialysis patients referred to Hemodialysis centers in Hamadan in 2018. The tools for collecting information in this research are questions about demographic information (gender, age, educational level, occupational and housing status, marital status of the disease), and a checklist for the cause of chronic renal failure based on high blood pressure, diabetes, kidney disease, and other reasons. Chi-square, Fisher’s exact test, and ANOVA and SPSS version 24 software were used to analyze the data in the inferential statistics section. Results: The results of the study showed that blood pressure, other causes (trauma, drugs, lumbar surgery, etc.), kidney disease, and diabetes were the main causes of chronic renal failure in hemodialysis patients. Prioritization of the causes of chronic renal failure was due to other causes, unspecified causes (15.3%), history of surgery (6.3%), anemia (5%), trauma (4.3%), shock (7.7% 2%), viral diseases (2%), drug use and congenital causes (1.3%), and poisoning of pregnancy and lupus (0.3%) were among the most important reasons for end-stage renal disease (ESRD) in these patients; also subset renal diseases were the most important causes of chronic renal failure in hemodialysis patients, kidney stones (3. 3%), polycystic kidney (0.7%) and glomerulonephritis (0.3%), respectively. Conclusions: According to the results of this study, it can be concluded that by promoting screening methods in patients at risk, prevention of end-stage renal failure can be prevented.