Objective To assess the early left heart function after kidney transplantation in young uremia patients using three-dimensional speckle-tracking echocardiograph. Method 31 young uremic patients who successfully underwent renal transplantation (renal transplantation group) and 31 healthy volunteers of the same age and sex (control group) were selected. Routine echocardiography and 3D-STI indexes were measured in normal control group and renal transplantation group (preoperative, 1 month and 3 months after operation); The differences of left ventricular global longitudinal systolic peak strain (GLS), left ventricular global radial systolic peak strain (GRS), left ventricular circumferential systolic peak strain (GCS) and left ventricular area systolic peak strain (GAS) were compared. Results GLS, GCS, GRS, and GAS in the kidney transplantation group before surgery were lower than those in the normal control group (P<0.05). Compared to preoperative, there was no significant difference in LVGLS one month after surgery in the transplantation group, while GCS, GRS, and GAS were lower (P<0.05); GLS, GCS, GRS, GAS were all higher three months after operation than those before operation in the transplantation group (P<0.05). Three months after operation, there was no significant difference in GCS and GRS between the normal control group, and GLS and GAS were lower than those in the normal control group (P < 0.05). Conclusion 1. GLS and GAS are sensitive indicators of myocardial damage in patients with uremia, and GRS and GCS are the main factors to maintain cardiac function in patients with uremia; 2. The structure and function of the heart in the early stage of kidney transplantation in young uremia patients have been effectively improved.