Cardiovascular diseases are among the principle causes of morbidity and mortality in children with chronic renal insufficiency. The principle alternations are left ventricular hypertrophy, vascular diseases and coronary artery disease ( Messus et al., 2000; Vatikus, 2000 ). Cardiovascular (CV) complication accounts for more than 50% of death in children on renal replacement therapy, a much higher proportion than in the general population. Myocardial damage represents nearly half of these CV deaths ( Parfrey and Harnett, 1994 ). The specificity of different cardiac markers has been the subjects of many previous studies. The creatine kinase-MB ( CK-MB ) can be expressed up to 20% of total creatine kinase activity in human skeletal muscles ( ms ). Therefore, CK-MB is not 100% specific for the heart. On the other hand, cardiac troponin-I has been described and shown to be 100% specific for the heart. While cardiac troponin – T is expressed in diseased and regenerating human skeletal ms ( Apple, 1999 ). Therefore, troponin-I seems to be a sensitive indicator of cardiac cell injury and measurement of troponin I seems to be useful in ruling out cardiac