Renal failure because of chronic kidney disease (CKD) leads to increased accumulation of uremic toxins due to decreased glomerular filtration rates. This in turn has a bearing on other metabolic functions in the body. Hemodialysis in end stage renal disease helps in elimination of toxic metabolites but long-term dialysis and the underlying chronic inflammation could affect immune cell activity, one of the main factors contributing to CKD associated complications and mortality. In this review, we tried to compile the important immune cell types and their different parameters that are altered in hemodialysis patients and the downstream impact of such alterations.