Cardiovascular disease in uremic patients is a major concern to the nephrologists because it represents the main cause of morbidity and mortality in chronic renal failure patients, both predialysis and while on dialysis therapy. Of note, a high prevalence of cardiovascular morbidity is already present at start of maintenance dialysis, and is predictive of subsequent mortality on dialysis. Cardiovascular disease progresses over years prior to the onset of ESRD, because risk factors develop from the early stage of chronic renal insufficiency. However, cardiovascular disease may be prevented or attenuated in patients who benefit from early, regular care of cardiovascular risk factors.Cardioprotective therapy thus has become a cornerstone in the Management of chronic renal failure patients, in conjunction with renoprotective therapy. Cardioprotective strategy involves optimal treatment of hypertension, anemia, fluid overload, dyslipidemia, hyperhomocysteinemia and calcium phosphate disorders to achive a maximal efficacy, such treatment has to be initiated as early as possible in the course of renal failure