Abstract Background Worldwide, chronic kidney disease is a serious health issue. Changes in erythrocyte morphology and function are induced by hemodialysis (HD), which affects the efflux of water over the membrane of erythrocytes. Objective This study aimed to demonstrate alterations in red cell indices and hematocrit (HCT) in chronic kidney disease patients receiving maintenance HD. Patients and methods The cross-sectional study consisted of 120 known end-stage kidney disease patients receiving maintenance HD at Ain Shams University Hospitals. Complete blood count by automated analyzer were used to compare blood counts before and after HD. Statistical approaches were used to examine the data (paired sample t test). Results There was a dramatic increase in HCT in the postdialysis state as opposed to the predialysis state HCT level (P<0.001). The change in HCT level is in a close proximity to and a good correlation with interdialytic weight gain and the duration of HD. Conclusion Important alterations in hematological parameters were observed in patients receiving maintenance HD, according to the findings of this study. Some of these changes can be attributed to ultrafiltration during session while others have yet to be explored.