Bone and joint complications of haemodialysis and renal transplant managed at Auckland Hospital have been reviewed. All pathological fractures in patients on haemodialysis united with conservative treatment and a cervical spine infection resolved following currettage of the lesion. Avascular necrosis was the main complication following renal transplant, the earliest pathognomonic radiological sign being a lucent line parallel to the articular surface, although this was often preceded by symptoms. Conservative management successfully controlled symptoms of femoral condylar and humeral lesions but only temporary relief was gained when the hip was involved. Total hip replacement, however, gave good results in all cases (10 hips) without significant operative complications.