Objective: Cardiovascular diseases and cardiac complications are the major causes of death in patients with end-stage renal disease. The purpose of this retrospective study was to evaluate the operative outcome of dialysis patients undergoing cardiac surgery at a single institution, and to clarify the association between in-hospital morbidity and mortality in both dialysis and non-dialysis patients undergoing cardiac surgery. Material and Methods: Fifty-four dialysis-dependent renal failure patients underwent cardiac surgery. A similar number of matched controls (n= 54) were selected based on age, sex, year, type of operation and occurrence of co-morbid diseases for the purpose of this analysis. Results: Operations performed in the dialysis group included coronary artery bypass grafting (CABG) alone (n= 43), CABG with valve surgery (n= 4), valve surgery alone (n=4), Benthall procedure (n= 1), and repair post-myocardial infarction ventricular septal defect (n= 1). Chronic renal failure patients had more postoperative complications and mortality rates compared with controls. There were 7 deaths in dialysis group, whereas 2 in control group (12.9% vs 3.7%). Sepsis, prolonged ventilation, stroke, and cardiac failure were the causes of death in dialysis group. Conclusion: Cardiac and renal function are intimately related, with each having significant influences on the other. Dialysis-dependent renal failure is associated with an increased morbidity and mortality following cardiac surgery. Our study has been limited by small numbers but, we have detected which cardiac surgery can be performed on dialysis patients with acceptable morbidity and mortality levels. Copyright © 2010 by Türkiye Klinikleri.