Cardiovascular disease is a major cause of morbidity and mortality among patients with chronic renal failure. CVD mortality is approximately 10 to 30 times higher in patients treated by dialysis compared with patients in the general population, despite stratifying for gender, race, and the presence of diabetes. The high prevalence of CVD in incident dialysis population suggests that CVD begins during or before the stage of CRI. Left ventricular hypertophy is the most frequent alteration in end stage renal disease. There is also intimal -medial thickness of large capacitance arteries.The aim of this work is to evaluate cardiac and vascular changes in renal failure and to analyze the relation between arterial alterations and left ventricular structures and to correlate findings to biochemical parameters.. Our results showed that end stage renal disease patients had greater left ventricular diameter, wall thickness and mass and increased common carotid artery diameter and intima media thickness, increased pararthoromne level and homocystiene than the control group.