Cardiovascular disease (CVD) is the major cause of death in renal failure. Available data demonstrate that chronic inflammation, a non-traditional risk factor which is observed commonly in uremic patients, play a key role in the genesis of CVD in ESRD. Additionally, inflammation is associated with congestive heart failure. There is evidence that a chronic inflammation with activation of C-reactive protein, interleukin-6, tumour necrosis factor alpha and other pro-inflammatory cytokines is associated with increased oxidative stress and endothelial dysfunction in ESRD patients. Strong relations between inflammation, oxidative stress and atherosclerosis in ESRD patients suggest that suppression of the vicious cycle of inflammation and atherosclerosis (MIA) would improve survival in ESRD patients. Therefore, the early stage of chronic renal failure is the perfect time to start therapeutic interventions and especially to protect against development of cardiovascular risk factors.