The development, diversification and improvement of haemodialysis and transplantation techniques have radically altered the prognosis of end-stage chronic renal failure, a condition that is still inexorably lethal in many countries. In France, it is estimated that up to 20,000 patients are being kept alive by these treatments, including transplantation. The available follow-up data show that a survival of 30 years, and perhaps more, can now be expected, at the cost of cardiovascular and osteo-articular complications the incidence and severity of which should be reduced in the years to come. It is by a carefully planned recourse, based on each patient's clinical status and occupation, to the whole range of these complementary treatments that survival time and quality will be further improved.