There is a hypothesis that a subgroup of patients with reversal of systolic dysfunction following hemodialysis have fluid overload. However, the underlying pathology has not been understood in those patients without significant fluid overload. Inflammatory markers have been found to be raised in chronic kidney disease, which prompts the theory for an underlying inflammatory pathology as a cause of reversible cardiac dysfunction in this group of patients. We studied 52 patients with chronic kidney disease. There were 29 patients with systolic dysfunction. Twenty three patients with preserved systolic function, had diastolic dysfunction. Of the 29 patients with systolic dysfunction, 10 patients had significant improvement in NYHA functional class, left ventricular dimensions, left ventricular ejection fraction . None of the patients had significant changes in dry weight. These patients had the highest baseline serum levels of troponin I which decreased significantly with recovery of cardiac function along with the c reactive protein levels. Those patients with C reactive protein greater than median change had significant improvements in LVIDs and EF.