Introduction: Chronic kidney disease (CKD) in children poses a significant health challenge, potentially affecting cardiac function. 
Aim of the study: To investigate the impact of chronic kidney disease in children on cardiac functions using 2D echocardiography and tissue Doppler, as well as measuring cardiac biomarkers (Troponin I & CK-MB) to correlate the results with the degree of cardiac affection. 
Methods: This cross-sectional study conducted at the pediatric nephrology unit of our university hospital from February 1, 2022, to January 31, 2023. Patients aged 1 year to 18 years diagnosed with CKD were included, with a control group matched for age and sex. Comprehensive medical history, systemic examinations, routine assessments, and cardiac evaluations with echocardiography were performed. Cardiac biomarkers were measured at the beginning of the study and after 6 months. 
Results: The study revealed higher systolic blood pressure, altered growth patterns, and a variety of etiologies for CKD. Significant differences were observed in serum creatinine, eGFR, serum CKMB activity, and Troponin I level between patients and controls. Echocardiographic parameters such as IVSD (interventricular septum thickness), LVPWD (left ventricular posterior wall thickness), and LVMI (left ventricular mass index) were significantly higher in the CKD group. Tissue Doppler analysis indicated diastolic dysfunction in patients with CKD, with correlations between biomarker levels and cardiac parameters. 
Conclusion: Children with CKD exhibit notable cardiac alterations, as evidenced by elevated biomarker levels and echocardiographic findings. Hypertension, CKMB, and Troponin I emerge as significant predictors of cardiac affection in this population.