OBJECTIVE: We examined clinical and laoratory features retrospectively in 56 patients at the start and after the chronic maintenance hemodialysis in order to provide a more complete picture of the uremic symdrome in the dialysis era. for deciding the time when chronic hemodialysis must be started. METHODS: The records of 56 patients began chronic hemodialysis treatment at the Han Yang University Hospital from 1995 august until 1997 august were reviewed retrospectively. The information gathered included demographic data, renal diagnosis, uremic symptoms, biochemical values. RESULTS: The most prevalence of manifestation of uremia was general weakness (67.9%). Unexpected fin-dings were the wide ranges of serum creatinine levels (3.5 to 19.4mg/dL) and blood urea nitrogen levels (19 to 204mg/dL), creatinine clearance rate (1.2-17.4mL/ min), and the frequency of hyponatremia (19.6%), hypo-albuminemia (69.6%), and the anion gap above 14mByL was (66.7%). There was higher potassium leve1 in diabetes mellitus patients than non-diabetes mellitus patients(6.2+/-1.6mEq/L VS. 4.9+/-1.0mEq/L,p=01). Patients laboratory values were changed after the chronic maintenance hemodialysis-Albumin(3.2+/-0.8 to 3.6+/-0.5gm/dL, p=0.01), calcium (7.6+/-1.2 to 8.7+/-1.9mg/dL, p=0.01), he-matocrit(23.0+/-4.7 to 27.7+/-4.2% , p=0.01), phosphorus (5.6+/-2.1 to 4,6+/-1.4mg/dL, p=0.01), pH (7.30+/-0,1 to 7.35+/-0.2, p>0.05), anion gap (22,0+/-11.0 to 12.1+/-8.8mg/dL, p>0.05). CONCLUSION: Finally, uremic symptoms were expressed mainly gastro-intestinal and respiratory symptoms. Chronic renal failure associated with diabetes mellitus was earlier on set of uremic symptoms and higher level of serum potassium level than other underlying diseases. Uremic symptoms and laboratory values were almost corrected but metabolic acidosis was not corrected significantly after the chronic maintenance hemodialysis.