The article presents anaesthetic considerations in hemodialysed patients in the course of systemic rheumatic diseases undergoing orthopaedic surgeries. Dialysed patients with ASAIII where scheduled for total knee atrhroplasty and reoperation of total hip arthroplasty. Regional anaesthesia was performed in all patients. Follow-up observations presented organ damage due to chronic renal failure, hemodialysis, disease activity and its treatment. The advantages and disadvantages of various therapies were considered. In conclusion it was stated that unilateral spinal block makes a useful anaesthesia technique also in patients with chronic renal failure in the course of total joint replacement procedure.