In India, there is rising burden of chronic diseases like hypertension and diabetes. It has been estimated that 25-40% of these patients are likely to develop CKD, with a significant percentage requiring renal replacement therapy. Haemodialysis is the most common method which is used to treat advanced and permanent kidney failure. The derangements in the metabolism of several toxic and trace elements such as antimony, arsenic, cadmium, molybdenum, nickel, and selenium have been reported for several decades in patients with chronically reduced renal function. Overall, the available literature suggests that the blood levels of some elements such as cadmium, chromium, fluorine, iodine, lead and vanadium are high in ESRD.