Background: Renalase is a blood-secreted protein produced only by the kidney; its blood level approximately 3–5 μg/ml. The Left ventricular hypertrophy (LVH) is defined by an augmented left ventricular mass that may be measured via echocardiography or magnetic resonance imaging (MRI). The aim of the present study was to study whether Renalase is a marker or has a potential role in developing myocardial hypertrophy in CKD patients under hemodialysis (HD) treatment. Patients and methods: To achieve this target, 90 patients on maintenance HD were incorporated in the present study. Results: The mean renalase levels were 61.7±67.5 ng/mL in HD patients. The cutoff value of Renalase was >57.9 ng/ml with a sensitivity of 92.3% and a Specificity of 84.0%. The mean LVMI of the studied dialysis patients was 138 g/m2. The majority of cases were severely abnormal (60%). There was a statistically significant difference between the age groups and the LVMI among dialysis patients. The level of Renalase was significantly increased with the moderately and severely abnormal LVMI among dialysis patients. The present study disclosed statistically significant relations between the duration of dialysis and Renalase, HDL, CRP, and LVMI. There were significant relations between the serum renalase and s. creat, bl. Urea, Ph, LVMI and dialysis vintage. Also, there were significant positive relations between LVMI and Hb, CRP, and dialysis vintage. Conclusion: Renalase could be a novel predictive biomarker in the assessment of LVH, which is closely associated with the increased risk of death in HD patients.