The pulse pressure is the difference in between the systolic pressure and diastolic pressure. It has been considered as a total cardiovascular risk factor, the high blood pressure on the systolic side can favor the ventricular hypertrophy and the left ventricular failure, and, as well, the oxygen demand of the myocardic muscle, therefore, low pressure values on the diastolic pressure is a limiting factor of the coronary perfusion and thus, it elevates the risk of ischemia. Cardiorenal syndrome is an state of advanced non-regulation between myocardic muscle and kidney, which involves the organic damage of both organs, both acute or chronic which induces the disfunction of both of them, in which it's physiological functions will use a compensation mechanism that will develop long-term repercussions, leading to ventricular hypertrophy, dilation and heart failure. Objective: correlate pulse pressure relating it to type IV cardiorenal syndrome and positive Peguero-Lo Presti Index on patients with chronic kidney disease stage G5. Methodology: Observational, longitudinal-prospective study of 74 patients that meet the requirements of the inclusion criteria, Through the instrument the data has been collected and everyone had been examinated as well the pulse pressure functional capacity, 12 derivations electrocardiogram to determine the Peguero-Lo Presti index, transthoracic echocardiogram, creatinine and urea. Results: indicates that, Elevated Pulse Pressure on Type IV cardiorenal syndrome is a predictive factor of heart hypertrophy and dilation, and, Peguero-Lo Presti index has a high sensibility and specificity to make electrocardiographic diagnosis on ventricular hypertrophy and dilation.