Congenital anomalies of urinary system are of wide spectrum ranging from mild, asymptomatic malformations to severe fatal conditions. To investigate occurrence of congenital anomalies in urinary system. It was a cross-sectional study. Study populations were Sudanese patients with ESRD on regular hemodialysis attending Gezira Hospital for Renal Diseases & Surgery, Gezira State, Sudan. Independent variables were horseshoe kidney, polycystic kidney disease, double ureter or ureteral duplication, ureteropelvic junction obstruction, posterior urethral valves, hypogenesis, agenesis, and kidney position. Dependent variable was hemodialysis. Investigation was done using abdominal ultrasound. Personal data was obtained using a questionnaire. Data was analyzed using SPSS version 21. P-value ≤ 0.05 was considered statistically significant. Results: Thirty one (62%) of respondents was male. Minimum age was 19 years while maximum age was 70 years. Maximum affected age group was age group (36-45) years; followed by age groups (46-55) and (56-65) years. Minimum age at which disease was diagnosed was 13 years. Overall prevalence was 12%. Four types of congenital anomalies were encountered and these are: polycystic kidney disease, uretero-pelvic junction obstruction, hypogenesis, and agenesis. Minimum disease duration was 1 year while maximum duration was 16 years. Mean duration was 6.42 years. Gender distribution of these types was as follows: Male (Two cases of polycystic kidney disease, one case of ureteropelvic junction obstruction, and one case of agenesis); female (one case of polycystic kidney disease, and one case of hypogenesis). Duration of disease is higher among male. Conclusion and recommendation: The current study highlighted a significant statistical relationship of the congenital anomalies in the urinary system among respondents and duration of ESRF. Screening for presence of congenital anomalies of renal system among general population of Central State may be of great help.

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