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Background: B2-microglobulin (B2M) is recognized as a surrogate marker of middle-molecule uraemic toxins and is a key component in the genesis of dialysis-associated amyloidosis.Objectives: To investigate the relation between hidden cardiac dysfunction in one side and B2M levels, conventional risk factors low hemoglobin levels, and aging on the other side. Subjects and methods:This was a case control study conducted on 50 patients aged 20-60 years with ESRD on regular HD and 50 apparently healthy individuals at El-Mokattam Insurance Hospital from September 2019 till March 2020.Results: There were statistically significant differences between groups regarding B2M, EF, LVMI, intraventricular septal thickness and LVEDD. There were no statistically significant differences between groups. Patient's B2microglobulin in Group (A) ranged between 76.00-109.70 with mean±S.D. 94.162±9.735, while in Group (B) ranged between 0.78-3.29 with mean±S.D. 1.956±0.704. There were statistically significant differences between groups. Patient's LVMI in Group (A) ranged between 111.87-131.59 with mean±S.D. 123.41±5.675, while in Group (B) ranged between 82.02-104.84 with mean±S.D. 91.63±7.236. There were statistically significant differences between groups. Patient's LVEDD in Group (A) ranged between 5.94-7.56 with mean±S.D. 6.79±0.505, while in Group (B) ranged between 3.27-5.25 with mean±S.D. 4.25±0.571. There were statistically significant differences between groups. Patient's LVESD in Group (A) ranged between 4.80-5.73 with mean±S.D. 5.34±0.250, while in Group (B) ranged between 2.87-3.65 with mean±S.D. 3.27±0.243. There were no statistically significant differences between groups. Conclusion:Plasma B2M level was significantly and directly correlated with some cardiac performance factors such as LVMI, LVEDD, and LVESD. It was also significantly and inversely associated with GFR, albumin and Hb.

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