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In this study, we sought to investigate the morbidity and mortality due to chronic renal failure (CRF) in a hospital with very limited access to renal replacement therapy. We did a retrospective study conducted at the Department of Nephrology at Donka National Hospital in Conakry (Guinea) over a period of 6 years, from January 1st 2006 to December 31st, 2011. Were included into the study, all patients hospitalized in the ward for chronic renal failure whose records were complete; 484 records (H 56.40% F 43.60%) were used. The average age was of 41.9 ± 15.17 years (15- 80 years). Three hundred and thirty-seven patients (69.63%) were under educated. Housewives and workers accounted for 55.60% of the population. Renal failure was moderate in 14%, severe in 21% and renal failure in 65%. Proteinuria was positive in 359 patients. Probable causes were chronic glomerulonephritis (37.8%), vascular nephropathy (31.2%), interstitial nephropathy (9.9%), diabetic nephropathy (7.4%), a HIVAN (3.3%), polycystic kidney disease (1.9%); the nephropathy was undetermined in 8.5% of cases. The risk factors for renal disease were hypertension in 371 cases (76.65%), consumption of nephrotoxic drugs in 328 cases (67.76%), smoking in 99 cases (12.39%) and diabetes in 51 cases (10.5%). Only 315 patients underwent hemodialysis; 20% died. Among the causes of death: anemia, heart failure, HIV, pericarditis, and stroke were statistically significant. For full article: https://www.omicsonline.org/open-access/in-hospital-morbidity-and-mortality-of-chronic-renal-disease-in-a-country-where-access-to-dialysis-is-limited-2161-0959-1000195.php?aid=41007