Adrenomedullin has been shown to be increased in case of cardiac and renal impairments, in relation with the severity of the diseases. This work was performed to investigate whether an increase in circulating Adrenomedullin might be related to cardiac functions in RTRs.Methods: thirty eight subjects, 28 RTRs and 10 healthy controls participated in the study. After 15 min rest in supine position, Heart rate, systemic blood pressure were measured together with cyclosporine trough levels, creatinine and ADM. Systolic and diastolic cardiac functions were assessed, using Doppler echocardiography.Results: creatinine and Adrenomedullin (130.7 ± 51.6 pg/ml vs. 31.9 ± 14.4 pg/ml, p=0.0001) were significantly increased in RTR, (60 ± 24.8 months after renal transplantation). RTR was presented with increased LVMI (124.6 ± 51.7 g/m2). Cardiac systolic function was normal in RTR, but reduced mitral E: A ratio was observed in RTR (0.92 ± 0.3 vs. 1.4 ± 0.07, p= < 0.0001) reflecting their impaired left ventricular relaxation. Such a ratio was negatively correlated with Adrenomedullin (r= −0.5, p= 0.006)Conclusions: LVH is not uncommon after renal transplantation and cardiac diastolic dysfunction is a significant clinical concern and likely participates in increased ADM observed in RTR.