Abstract Objective To evaluate the effects of hemodialysis (HD) and peritoneal dialysis (PD) on left ventricular myocardial work indices (MWIs) in patients with end-stage renal disease using left ventricular pressure–strain loop (PSL) analysis. Methods 79 patients with stage 5 chronic kidney disease were grouped according to dialysis status: HD (n = 29), PD (n = 27), and no dialysis (ND; n = 23). Clinical data, laboratory and conventional echocardiographic parameters, global longitudinal strain (GLS), and the following MWIs were compared between groups: global work index (GWI), global constructive work (GCW), global waste work, and global work efficiency (GWE). Correlations between the MWIs and clinical parameters were analyzed as were MWI predictors. Results Age, gender, height, weight, other clinical characteristics, conventional echocardiographic parameters, and GLS values did not significantly differ between the three groups (all P >0.05). In the HD group, GWI and GCW were significantly lower than the PD and ND groups , GWW was significantly higher than the PD and ND groups, GWE was significantly lower than the PD group(both P <0.05) . GWI and GCW were positively correlated with GLS, left ventricular ejection fraction, systolic blood pressure, and diastolic blood pressure, but negatively correlated with interventricular septum thickness, dialysis time, and dialysis type(PD was denoted by 1, and HD by 2). Global waste work (GWW) was positively correlated with dialysis type, negatively correlated with GLS. GWE was positively correlated with GLS and left ventricular ejection fraction，while it was negatively correlated with dialysis type, interventricular septum thickness, and left ventricular posterior wall thickness (all P <0.05). Dialysis time and type were independent negative predictors of GWI and GWE respectively, Dialysis type was independent positively predictors of GWW. Conclusion HD has a greater impact on left ventricular systolic function than PD. PSL analysis can detect left ventricular systolic function impairment earlier than conventional echocardiography and GLS.