 Background Platelets play an important role in cardiovascular disease both in the pathogenesis of atherosclerosis and in the development of acute thrombotic events. Their importance in coronary disease and in acute coronary syndromes is indirectly confirmed by the benefit of antiplatelet agents particularly aspirin, clopidogrel, ticlopidine, and the glycoprotein IIbIIIa inhibitors in these disorders. Cardiovascular disease is the single best predictor of mortality in patients with end-stage renal disease, as it accounts for almost 50 percent of deaths. Patients with end stage renal disease ESRD have an increased tendency to bleeding due to platelet dysfunction that can be partly corrected by either hemodialysis or peritoneal dialysis in approximately two-thirds of cases. Currently there is only scant data concerning the relations between platelet function and cardiovascular risk in patients with ESRD. 