Echocardiography was performed in two gruops of patients with impaired renal function excluding those with diabetic renal failure. Group A was comprised of 19 patients who had recieved hemodialysis from 1 year to 5 years, and Group B, of 32 patients who had been undergoing hemodialysis for more than 10 years. Significant reductions in left ventricular diastolic dimensions and cardiac output were found in Group B. In these two groups, there were no statistically significant differences in left ventricular wall thickness and left ventricular ejection fraction. Left ventricular diastolic function was assessd by the ratio of the peak atrial velosity (A) to early diastolic velosity (E). 15 patients (83%) in Group A and 19 patients (76%) in Group B had left ventricular diastolic dysfunction. A high incidence of left ventricular diastolic dysfunction was revealed. Moreover, dilated and hypertrophic cardiomyopathy like patterns were observed in both groups. In Group B, significantly increased left ventricular wall thickness in patients with hypertension and reduced left ventricular systolic function in patients with dialysis hypotension were found.