Cell adhesion molecules play a pivotal role in many biological processes. Their membrane-bound forms take part in leukocyte migration in case of inflammation and therefore determine effective immune response. Uremia is a state of immunologic imbalance. By comparison with healthy controls, levels of soluble adhesion molecules are either elevated or lowered in chronic renal failure patients. This fact proves conclusively that activation and inhibition of immunocompetent cells coexist in end stage renal disease, thus showing the complexity of immune disorders in uremia. Taking into account the competitive action between circulating adhesins and their bound counterparts, one can come to the conclusion that soluble forms' dysregulation results in the blockage of membrane-bound adhesion molecules and leads to disordered adhesion. Although the effects of change in circulating adhesins' concentrations seem evident, the reason for this change is still unclear.