Cardiovascular diseases are the major cause of mortality in patients with end-stage renal disease (ESRD) undergoing dialysis. Among ESRD patients the atherosclerotic process progresses more dynamically than in the general population because of exposure to additional, non-traditional risk factors. Diagnosis of coronary artery disease based on history data, physical examination, and additional tests can be difficult due to the coexistence of many disorders and the influence of dialysis treatment. Studies to investigate the pathology of atherosclerosis in patients undergoing dialysis are needed.