Description:It is only a question of time until patients suffering from chronic or acute renal failure are facing further complications due to the long-time effects of dialysis. This publication provides a summary of the various risks and discusses options for avoiding or at least reducing them. One of the main risk factors is cardiovascular complications such as atherosclerosis, hypertension and hypotension. Modification of the dialysis regimen helps to control blood pressure and to improve nutritional status, quality of life, phosphorus and anemia, and, ultimately, survival. In this context, the GENIUS[registered] hemodialysis system is described. Other topics discussed include the importance of an adequate vitamin C supplementation, the biocompatibility of dialyzers, the role of biocompatibility in peritoneal dialysis with regard to glucose degradation products, and the role of cancer antigen 125 as an in vivo marker of biocompatibility in peritoneal dialysis.