Hemodialysis is a commonly used treatment for renal failure when a kidney has lost its ability to regulate fluids, electrolytes, acid/base balance and toxin removal from the blood. It helps the kidneys to excrete wastes and maintains the electrolyte balance in approximately 90% of end – stage renal disease (ESRD) patients. Albumin consists of one polypeptide chain of 585 amino acids and contains 17 disulfide bonds. Hypoalbuminemia is associated with mortality in patients with ESRD and maintaining optimum albumin levels is crutial in on hemodialysis (HD). In this study, we aimed to group ESRD patient having hemodialysis treatment in accordance to their etiology and investigate their blood albumin levels. Methods: This study etiology groups prevalent causes and groups the blood level albumin was designed to evaluate the long term hemodialysis treatment with in patients who are end-stage renal disease. In this retrospective study an annual 73-3=70 adult with end – stage renal disease accepted for renal replacement therapy (included 70 patients because 3 patients not used 4. criteria). The private hemodialysis center was analyzed % for the totally period 24 month and annual numerical. All the patients’ permissions have been taken. The data were compared with National Hemodialysis, Transplantation and Nephrology of the dialysis and transplantation Registry Report of Turkey, 2008. The etiology of ESRD has been determined in eight groupsasfollows: 1: the etiology was undetermined 2.: hypertensive patients, 3: patients with type II diabetes mellitus, 4.: patients with familial Mediterranean fewer, 5.: patients with polycystic kidneys, 6.: patients with uropathy, 7.: patients with chronic pyelonephritis, 8.: patients with other etiology causes. Results: Our study has shown, in a two – year study of annual 73-3 = 70 adult patients with end – stage renal disease in hemodialysis center. The first etiology groups, 24 month totally incidence (%); 16.5 % was undetermined (n=11), the second group: 19.9 % (n=14), 3.group: 38.9 % (n=27), 4.group: 4.3 % (n=3), 5.group: 6.7 % (n=5), 6.group: 3.7 % (n=3), 7.group: 1.7 % (5), 8.group: 8.3 % (n=2), etiology causes was accounted. Serum albumin levels were found in minimal in group 3 (3.76 g/dl) and maximum in group 5 (4,15 g/dl). Conclusion: Patients with type II Diabetes mellitus and hypertension were found to be the principal causes of endstage renal disease. On the other hand obesity was less seen as in developed countries.