Hepatitis C virus (HCV) infection in patients with chronic kidney disease (CKD) is a major cause of morbidity and mortality. HCV infection is associated with some glomerular disease. It also has a high incidence in patients on dialysis. Immunosuppressive drugs used after kidney transplantation may exacerbate liver injury, and may lead to graft failure. Patients with CKD have different clinical and laboratory features that affect the treatment of acute and chronic HCV infection. Acute HCV infection should be treated appropriately because the spontaneous viral clearance rate is low. Treatment decision in patients with chronic HCV infection is determined by CKD stage, progression of kidney damage and the nomination of kidney transplantation. In these patients, interferon and ribavirin drugs decrease treatment compliance due to their side effects and requirement of usage for a long time. Novel antiviral agents and regiments hold promise a high efficacy and a shorter lifespan. In this article, we review the characteristics of HCV infection and the features of the new direct-acting drugs in CKD.