Objective:To determine the association of plasma brain natriuretic peptide (BNP) level and left ventricular remodeling in patients with maintenance haemodialysis (MHD) and to evaluate the risk factors for increased BNP levels in this population. Methods: We measured the left ventricular diastolic dimension (LVDD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (PWT), according to ratio of early to late left ventricular filling velocity (Ve/Va) by tissue Doppler imaging in 85 patients with MHD. The patients were divided into two groups: left ventricular diastolic dysfunction (Ve/Va<1,n=36) and without left ventricular diastolic dysfunction (Ve/Va≥1, n=49). Plasma high sensitivity C-reactive protein (hs-CRP), parathyroid hormone (PTH) and BNP levels were determined from medical records. Results: Plasma BNP levels were significantly higher in patients with left ventricular diastolic dysfunction than in those without left ventricular diastolic dysfunction (P < 0.01). The area under the receiver-operating characteristic curve for BNP to detect left ventricular diastolic dysfunction was 0.724 (95% CI: 0.606-0.842, P < 0.001). According to LVDD, LVST and PWT, patients were further divided into three groups: the left ventricle with normal structure group, left ventricle with concentric hypertrophy group, and the left ventricle with eccentric hypertrophy group. Plasma BNP levels had significantly positive correlation with systolic blood pressure, pulse pressure, IVST, and PWT. Stepwise multiple regression analysis further revealed that SBP, IVST and PWT were independent risk factors for increased BNP levels (F=3.217, P=0.028). Conclusion: Plasma BNP level is significantly higher in MHD patients with left ventricular concentric hypertrophy and may be a biomarker for assessing left ventricular function. SBP, IVST and PWT are independent risk factors for increased BNP level.