Objective Four dimensional automatic left atrial quantification (4D Auto LAQ) was applied to evaluate the effects of different dialysis methods on left atrial structure and function in uremic patients from the perspectives of volume and strain, respectively.Methods 80 patients with confirmed uremia in the nephrology department of our hospital were selected and divided into a hemodialysis group of 41 cases (hemodialysis group) and a peritoneal dialysis group of 39 cases (peritoneal dialysis group) based on the dialysis method. Additionally, 35 healthy individuals who matched their gender and age were selected (normal control group).SConventional parameters were obtained by two-dimensional echocardiography: left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular ejection fraction (LVEF);SUsing 4D Auto LAQ to obtain left atrial strain and volume parameters: left atrial reserve longitudinal strain (LASr), left atrial ductal longitudinal strain (LAScd), and left atrial systolic longitudinal strain (LASct);SLeft atrial reserve phase circumferential strain (LASr-c), left atrial ductal phase circumferential strain (LAScd-c), and left atrial systolic phase circumferential strain (LASct-c);SLeft atrial maximum volume (LAVmax), left atrial minimum volume (LAmin), left atrial pre-systolic volume (LAVpreA), and left atrial ejection fraction (LAEF) were compared for differences in the above group parameters, and the correlation between 4D Auto LAQ strain and volume parameters was analyzed.Results ① Routine parameters: LAD, LVEDD, IVS, and LVPW in the peritoneal dialysis group and hemodialysis group increased compared to the normal control group, with a statistically significant difference (P<0.05). There was no statistically significant difference in LVEF between the groups (P>0.05);SThere was no statistically significant difference in LAD, LVEDD, IVS, and LVPW between the hemodialysis group and the peritoneal dialysis group (P>0.05)SStrain parameters: LASr, LAScd, LASr-c, and LAScd-c in the peritoneal dialysis group decreased compared to the normal control group, while LASct and LASct-c increased compared to the normal control group. LASr, LAScd, LASct, LASr-c, LAScd-c, and LASct-c in the hemodialysis group decreased compared to the normal control group, with a statistically significant difference (P<0.05);SThe LASr, LASct, LASr-c, LAScd-c, and LASct-c in the hemodialysis group were significantly reduced compared to the peritoneal dialysis group (P<0.05), and the difference was statistically significant (P<0.05). There was no statistically significant difference in LAScd between the two groups (P>0.05)SVolume parameters: LAVmax, LAmin, and LAVpreA in the peritoneal dialysis group and hemodialysis group increased compared to the normal control group, while LAEF decreased compared to the normal control group, with a statistically significant difference (P<0.05);SThe LAVmax, LAmin, and LAVpreA in the hemodialysis group increased compared to the peritoneal dialysis group, while LAEF decreased compared to the peritoneal dialysis group, with a statistically significant difference (P<0.05).SIn correlation analysis, LAEF is positively correlated with the absolute values of LASr, LAScd, LASr-c, and LAScd-c, with correlation coefficients of 0.531, 0.522, 0.705, and 0.686, respectively.Conclusion 4D Auto LAQ can evaluate the changes in left atrial structure and function caused by different dialysis methods, and hemodialysis has a more significant impact on left atrial structure and function than peritoneal dialysis.