Background: The hallmark of gout is hyperuricemia. This substance has ties to cardiovascular disease's pathophysiology, which is the main killer of dialysis patients. Diabetes, insulin resistance, and other cardiovascular diseases as well as hypertension are all linked to hyperuricemia. Death from any cause is prevented by high SUA levels. Smaller studies found J￾shaped relationships between SUA and all-cause mortality. In line with its function in protein metabolism, a recent study suggests that SUA could be used as a nutritional status indicator in hemodialysis patients. Rather than a high SUA, a superior nutritional state may explain survival connections. In HD patients, LVH with diverse etiologies is predictive of CV mortality and morbidity. Aim: to investigate the relationship between left ventricular morphological and functional problems and pre￾and post-dialysis uric acid differences in individuals receiving maintenance hemodialysis. Subject and Methods: This study was carried out on ESRD patients in Internal Medicine Department of Benha University in the hemodialysis unit, where 100 patients were selected. Results: There were high statistically significant differences between the studied patients systolic and diastolic blood pressure before and after hemodialysis. There were high statistically significant differences between the studied patient’s serum level of uric acid, creatinine and urea before and after hemodialysis. Conclusion: This study found a strong relationship between uric acid and both LV parameters and ejection fraction. We discovered through regression analysis that serum uric acid was an important indicator of LV ejection fraction