Objective: To determine the performance of hemodialysis facilities judged by morbidity, mortality and the type of patients treated (diabetics and elderly). Materials and methods: We performed a prospective follow up study in 7/28 hemodialysis centers during 1993 in Lima, Peru. The age, sex, number of diabetics frequency and durations of hospital admission and the condition of the patients at the end of the study were recorded. Results: 521 patients were evaluated. Mean age was 49 ± 15 years, 57.8% were male, 42.2% females and 29.5% were older than 60 years. Diabetic nephropathy was the cause of end stage renal failure in 13%. Results were expressed in adjusted rates per patient/year at risk (PYR). The mortality rate was 0.115/PYR, the transplantation rate was 0.078/PYR, the rate of patients lost to follow up was 0.264/PYR. Absolute values were used to generate expected and observed mortality rates, in order to allow calculation of individual center performance rate. The highest performance rate was 2.96 PYR and the lowest rate was 0.48 PYR. Conclusions: Hemodialysis center performance may be objectively assessed by evaluation of rates for morbidity and mortality.