Abstract: AIM:To analyze the risk factors of acute cardiac arrhythmias in patients with HD. METHODS: 102 cases with HD were selected retrospectively from May 2011 to May 2012 during maintenance hemodialysis, record the frequency, type and treatment strategies of dialysis-related acute arrhythmia, then analyze the risk factors. RESULTS: A total of 1 046 cases of acute arrhythmia occurred in the 8 211 cases of HD patients (12.7%) including 306 cases of premature ventricular beats, 177 cases of atrial premature beats, 138 cases of atrial fibrillation, 81 cases of paroxysmal supraventricular tachycardia, 77 cases of ventricular tachycardia, 228 cases of sinus tachycardia and 39 cases of sinus bradycardia. The preliminary findings showed that the higher rate of dialysis-related arrhythmia was associated with older age, hypokalemia after hemodialysis, ultrafiltration volume ≥3 kg, anemia, and basic factors such as heart disease. CONCLUSION: The causes of dialysis-related arrhythmia are various and include patients with underlying heart disease, hypokalemia, older age, ultrafiltration volume and anemia and other factors. Active correction of risk factors induced by dialysis-related arrhythmia can avoid or reduce dialysis-related acute arrhythmia.