With a growing population of patients with chronic kidney disease (CKD), it is critical that clinicians are aware of the consequences of how kidney failure affects the pharmacokinetics and pharmacodynamics of cardio- vascular medications. This is particularly true in patients on chronic hemodialysis. Approximately 30% of medication-related prob lems in ambulatory hemodialy- sis patients occurred with agents used to treat cardiovas- cular disease (1). These ï¬ndings were reinforced in another study that showed that 60% of cardiovascular medications were inappropr iately dosed or contraindi- cated in hospitalized patients with CKD (2). This article will review some of the most common drug use errors seen in our hemodialysis population .