OBJECTIVES: This study aims to describe clinical and demographic characteristics of end-stage renal disease (ESRD) patients on renal replacement therapy in the São Paulo state, Brazil. METHODS: Cross-sectional analysis of São Paulo renal replacement therapy claims as reported in Brazilian Ambulatory Information System (SIA/DATASUS) database in January 2009.  Repeated records were excluded using identification code, age, sex, and first treatment date as compatibility criteria. The following variables were investigated: diseases associated to ESRD, anemia, glucose levels, HCV, HbSAg, HIV, urea reduction ratio (URR), vascular access, and type of renal replacement therapy. RESULTS: A total of 18,360 patients were identified among 18,886 available claims, with a mean age of 54.23 years (SD=15.53) and 57.7% male. Among 8,305 patients for whom secondary ICD-10 codes in addition to those related to renal failure itself were available, the more frequent conditions associated to ESRD were diabetes mellitus (17.5%), hypertension (26.4%) and glomerulonephritis (8.81%). Continuous Ambulatory Peritoneal Dialysis (CAPD) was the therapeutic strategy for 9.9% of patients compared to hemodialysis in 90.1%. 58.4% of all patients had hemodialysis vascular access and 50.9% had URR > 65%. Prevalence of positive HCV, HbSAg and HIV serology tests was 4.3%, 0.9% and 0.6%, respectively. Anemia and glucose levels > 126 were present for 45.4% and 19.6% of patients. The total amount paid for renal replacement therapy procedures in January 2009 in São Paulo state was 36,073,377 BRL. CONCLUSIONS: Although diabetes and hypertension renal complications can be prevented, they accounted for 43.9% of all conditions related to renal disease among the studied population. The findings also indicate that CAPD is still underused in Brazilian healthcare public system compared to other countries, as reported by previous local studies.