Background: Serum uric acid [SUA] levels are frequently elevated in patients with chronic kidney disease [CKD]. Higher levels of SUA have been associated with cardiovascular disease. However, the direct relationship between SUA and left ventricular [LV] hypertrophy and diastolic dysfunction in CKD patients remains unclear.
Aim of the work: To investigate the correlation between serum uric acid levels and LV hypertrophy as well as LV diastolic dysfunction in CKD patients with preserved LV systolic function.
Patients and Methods: We studied 90 CKD patients with estimated glomerular filtration rate less than 60 ml/min/1.73 m² and normal LV ejection fraction. Patients were divided into 3 groups according to their SUA levels: less than 10 mg/dl, 10-15 mg/dl, and more than 15 mg/dl. All patients underwent comprehensive transthoracic echocardiography including tissue Doppler imaging for the assessment of LV hypertrophy, geometry, and diastolic functions. 
Results: Left ventricular end-diastolic diameter, left ventricular mass index, and left atrial volume index were significantly higher in patients with SUA >15 mg/dl. Mitral peak early diastolic velocity, mitral annular early diastolic velocity, and E/e' ratio were significantly altered in patients with SUA >15 mg/dl, indicating impaired LV relaxation and increased filling pressures.
Conclusion: Higher serum uric acid levels are significantly associated with increased LV hypertrophy and diastolic dysfunction in CKD patients with preserved ejection fraction. Serum uric acid may play a role in the development of cardiovascular complications in this population.