Superficial dermal vasodilatory capacity and indirect segmental systolic arterial pressure were measured in 10 patients with end-stage renal failure and 13 controls. Laser-Doppler flowmetry was used to measure skin blood flow on the dorsum of the feet prior to and during local skin heating to 40 °C. Basal skin blood flow was not significantly different between the two groups (mean 0.8 ± (SD) 0.3 vs. 0.7 ± 0.2 U). Peak stimulated flow at 40 °C was significantly greater in the controls than in the azotaemic patients (10.0 ± 3.5 vs. 3.5 ± 1.6 U, p < 0.01). Stiffening of the major limb arteries was detected in the majority of the azotaemic patients and may have contributed to the reduction in vasodilatory cap