Background: End-stage renal disease (ESRD) is a series of biochemical, clinical and metabolic disorders that are directly or indirectly associated with high rates of symptom burden. Glomerular filtration rate <15 ml/min/1.73 m2 means kidney failure which treated by renal replacement therapy (RRT) (either dialysis or transplantation) . Hemodialysis initiated urgently in patients with uremic encephalopathy, pericarditis, life-threatening hyperkalemia, refractory acidosis and hypervolemia (pulmonary edema)

Aim of the work: comparison between hemodialysis patients' symptoms as regard duration of dialysis.

Patients and methods: This descriptive cross-sectional study was conducted at the hemodialysis unit in Minia university Hospital on 100 hemodialysis patients and divided into two groups according to duration of dialysis > 5 year with 43 patient and < 5 years with 57 patients, written informed consent was obtained.Patients included in the research were fulfilled the following criteria:1) Patients under regular hemodialysis for at least 3 months.2) 18-70 years of age of both genders.

3) Capacity to provide informed consent.

Results: hypoalbuminemia in addition to cardiovascular, respiratory, gastrointestinal, genitourinary, autonomic function and weight loss were significantly worse in the ≥5-year group of chronic hemodialysis. symptoms related to cardiovascular, respiratory, gastrointestinal, genitourinary, autonomic function and weight loss were significantly worse in the ≥5-year group.

Conclusion: symptom burden increased with dialysis duration.