Objective Two-dimensional speckle tracking strain imaging (2DSTI) was used to evaluate the left ventricular function in patients with chronic nephropathy and to explore the correlation between the global longitudinal peak strain of the left ventricle and renal function. Methods A total of 69 patients with chronic renal insufficiency diagnosed in our hospital from August 2016 to May 2019 were selected, including 36 patients with stage 2 and 3 chronic renal insufficiency (mild CKD group). 33 patients with stage 4 to 5 chronic renal insufficiency (moderate and severe CKD group) and 30 age and sex matched healthy volunteers (control group). The basic clinical data of all patients were collected, and the indexes of conventional echocardiography were measured by transthoracic echocardiography. It included interventricular septal end diastolic thickness (IVSTd), left ventricular end diastolic diameter (LVDd), left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), left atrial volume index (LAVI) and E/e". Left ventricle global longitudinal peak strain (GLS) of was measured by 2D-STI. Multiple linear regression was used to analyze the correlation between echocardiography parameters and glomerular filtration rate (eGFR). Results Compared with the control group, IVSTd and LAVI increased, eGFR and GLS decreased significantly in mild CKD group. Compared with mild CKD group, systolic blood pressure, total cholesterol, IVSTd, LVMI, LAVI, E "increased, eGFR and GLS decreased in moderate and severe CKD group. EGFR was negatively correlated with systolic blood pressure, IVSTd, LVMI and LAVI, while eGFR was positively correlated with GLS (P<0.05). After adjusting the influencing factors by multiple linear regression analysis, GLS and eGFR were still independently and positively correlated.Conclusion With the development of the disease, the left atrium enlarged and the left ventricular systolic function decreased in patients with chronic renal insufficiency. GLS is independently related to renal function. 2D-STI can sensitively reflect the changes of left ventricular function in patients with chronic renal insufficiency at different stages.