The time of patients' referral to dialysis predicts the clinical outcome of the therapy and significantly influences the mortality rate. The aim of the study was to assess the clinical and nutritional status and selected biochemical parameters (serum creatinine, urea, bicarbonate, calcium, albumin concentration) at the beginning of renal replacement therapy. We analysed medical history of 46 children (24 boys; 22 girls) aged 1 month-18 years (mean age 13.1 +/- 5.5 years). We divided them into late-referral and early-referral groups. 56% of the children were under nephrological care before the beginning of dialysis treatment. However, in 44% of the cases renal insufficiency had not been diagnosed before. It was found that the children who received no nephrological care in the past demonstrated significantly worse clinical and biochemical status at the beginning of the renal replacement therapy.