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Background: Cardiovascular diseases are prevalent in patients with chronic  kidney disease and represent the major hazard for mortality in this population . Left ventricular hypertrophy is a cardiovascular complication in patients with chronic kidney disease and end-stage renal disease. Left ventricular hypertrophy in dialysis patients has generally a bad prognostic value, because it represents a risk factor for the development of cardiac arrhythmias, ischemic heart disease, heart failure and sudden death. Objective: To study  left ventricular systolic functions by Echocardiography in patients with chronic renal failure on hemodialysis  program and their relation with some risk factors. Patients and Methods: 100 patients with end stage renal failure on dialysis were studied  by echocardiography, the patients were divided into two groups, the first group   with normal echo study , while the second group consisted of patients with left ventricular  systolic dysfunction. Risk factors  including age , sex , duration of dialysis , hypertension, DM, and hemoglobin levels were compared between the groups. Results: Left Ventricular  disorders occurred in 65% , 34% of patients showed left  ventricular  systolic dysfunction , , older age  group, longer duration of dialysis  , hypertension ,DM, and anemia were found to be significantly associated  with  left ventricular systolic dysfunction. Conclusion: Our study concluded that large numbers of end-stage renal disease patients have hypertension and diabetes as the etiology of their disease, which could be prevented by better approach in controlling blood pressure and blood sugar.         Anaemia is a major problem and as a predictor of cardiovascular risk factor for those patients. Echocardiographic Left Ventricular Study are prognostic predictors in chronic kidney disease patients, which suggest that echocardiography may play a vital role in assessing cardiac morphology and functions in those patients.