Abstract: Objective To investigate the changes of cardiac structure and function in maintenance hemodialysis（MHD） patients, as well as to explore the relationship between the changes and cardiocerebrovascular events. Methods The study included two parts:Cross-sessional study and prospective cohort study. 115 MHD patients were enrolled.Baseline anthropometric and laboratory parameters were measured and echocardiography was performed to assess the cardiac structure and function.The cardiocerebrovascular events during the 2 year follow-up period were documented. Results In all patients, valve calcification were observed in 92 (80%) patients, left ventricular hypertrophy in 80 (69.6%) patients, left atrial enlargement in 75 (65.2%) patients, pulmonary hypertension in 13(11.3%) patients.98 (85.6%) patients had cardiac diastolic dysfunction while only 9 (7.83%) patients had cardiac systolic dysfunction.Multivariate logistic regression analysis revealed that the independent associations of the different echocardiographic abnormalities were: valve calcification – increased age and lower serum triglyceride; left ventricular hypertrophy – higer systolic blood pressure; left atrial enlargement – lower blood diastolic pressure and urea reduction ratio. During the follow-up period ,there were 23(20.0%) cardiocerebrovascular events,18（15.7%） deaths, of which 12 were attributable to cardiovascular disease.In event group , the incidence of hypoalbuminemia and C- reactive protein (CRP) positive , left atrial size and LVMI were significantly higher than those of in control group(P <0.05).The independent risk factors for cardiocerebrovascular event were decreased serum albumin, positive CRP and left atrial enlargement. Conclusions Echocardiographic cardiovascular disease are already present in a very high proportion of MHD patients and are independent risk factor for adverse outcomes. Echocardiography should be performed periodically to detect early structural and functional changes in MHD patients .

Key words: Hemodialysis, Cardiovascular disorder, Echocardiography