Summary: Hepatitis C virus infection constitutes an important cause of liver disease worldwide. Patients with chronic kidney diseases, including patients on hemodialysis and kidney transplant recipients, represent a particular population among HCV infected patients. Not only is the infection much more frequent in this group, but also the consequences of chronic infection are more severe and progress more rapidly.Since the introduction of direct-acting antiviral agents (DAAs) the landscape of chronic HCV infection treatment has evolved substantially. DAAs allow for high efficacy of therapy with few adverse events. Extreme alertness is required on the part of the clinician in charge of treatment in patients with severe renal impairment and kidney transplant recipients due to the high risk of drug interactions. The high efficacy of interferon-free treatment creates an opportunity to receive an organ from an HCV-seropositive donor for patients remaining on a waiting list, prevents onward transmission of HCV and reduces the risk of complications in chronically infected patients. Further studies will allow for long-term efficacy and possible drug interaction assessment in patients with chronic kidney diseases.