The last five years, Lubumbashi records the emergence centers of dialysis. We achieved this study to evaluate the risk factors of death for the renal insufficient patients and the economic accessibility to this peak therapy. A cross sectional study based on a random sample of 53 patients has been completed in 2012. The data is analyzed using the SPSS 19.0 software. A significance level of p < 0.05 and Confidence interval fixed to 95%. The Fischer exact test and the odds ratio have been used. The participation rate was 65.4%. The mean age was 49.49 ± 13.30 years old and 60.4 % were aged > 50 years old. The sex ratio 0.3 women by men was noted. 83% of patients was private versus other category (p<0.05). 66 % are renal insufficient chronic patients versus 34 % of recent renal insufficient patients. 90% of patients were diabetic hypertensive. The patients' monthly income declared was US$ 205 for 52.8% of patients, US $ 525 for 34% patients and US $ 750 for 13.2% of patients versus US $ 1, 270 monthly mean care cost. The deaths are associated statistically with an interruption of the treatment (χ²=9.30, p=0.0022, OR= 8.5) and with the irregularity of treatment (χ²=8.65, p=0.0032, OR=6). Africa in comparison with countries of other continents, to invest in advanced medical equipment is a salutary measure, but the majority of patients are not able to pay the costs of health care. Our results shown that, the dialysis became an ultimate recourse for the renal insufficient patients at Lubumbashi city but the economic accessibility remains a major obstacle. Consequently, it's important to subsidize the health care of these patients.