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Abstract We aimed to study level of cardiac troponin T(cTnT) and its possible influence factorsin maintenance hemodialysis (MHD) patients. Blood was obtained from 123 MHD patients before undergoing hemodialysis. Patients with cardiovascular disease (CVD) had higher cTnT levels than those without CVD (0.062 [0.044 - 0.083] ng/mL vs 0.031[0.020 - 0.046] ng/mL, P = 0.002). Patients with diabetes mellitus (DM) had higher cTnT levels than those non-DM (0.061[0.042 - 0.102] ng/mL vs 0.044[0.025 - 0.064] ng/mL, P = 0.003). We found that in all MHD patients, cTnT correlated positively with age(ρ = 0.309, P = 0.001), glycated albumin (ρ = 0.192, P = 0.040), amino-terminal pro-B-natriuretic peptide (NT-proBNP) (ρ = 0.448, P < 0.001), high-sensitive C reactive protein(hsCRP) (ρ = 0.335, P < 0.001), carotid artery intima-media thickness (ρ = 0.315, P = 0.004) and left ventricular mass index(ρ = 0.369, P < 0.001); negatively with pre-albumin(ρ = -0.280, P = 0.002), high density lipoprotein cholesterol(ρ = -0.201, P = 0.047). Age (β = 0.204, P = 0.043), NT-proBNP (β = 0.299, P = 0.010) and left ventricular mass index (β = 0.345, P = 0.003) were independently associated cTnT. Receiver operating characteristic (ROC) curves analysis showed the correlation between cTnT and CVD was more closely than NT-proBNP and hsCRP, the correlation between cTnT and left ventricular hypertrophy was lower than NT-proBNP, and higher than hsCRP. In conclusions, serum cTnT is markedly elevated in MHD patients; Serum cTnT is associated with advanced age, fluid overload, malnutrition, microinflammation, left ventricular hypertrophy and CVD in MHD patients.