The capacity of hemodialysis care in Ivory Coast has increased in recent years. Indeed, the policy of decentralization of hemodialysis services has allowed the opening of hemodialysis centers in the interior of the country, including the one that was the subject of our study. Our patients were mostly young adults with an average age of 41 years. Dialysis was initiated in our center in 85.9% of cases. The first session at the center was performed on a catheter in 81% of cases. Anemia was found in 90.6% of cases and its management by ESA was possible in 32.9%. Mortality was 26%. The more chronic kidney disease worsens, the more it requires continuous and simultaneous monitoring of various, sometimes divergent, parameters. This finding suggests that it justifies the development of a medical program to ensure continuity of care. This should include early identification of patients, an education program to help patients manage their chronic disease, and an evaluation of the quality of care. Finally, it should be noted that optimized management and renovation of pre-existing dialysis facilities is profitable for the patient and for the low-income population.