【Abstract】 Objective To investigate the relationship between renal aminase, pulmonary hypertension and heart rate variability in patients with maintenance hemodialysis. Methods 150 maintenance hemodialysis patients in Ya'an People's Hospital and Jiulongpo District of Chongqing Second People's Hospital were selected. The patients were divided into pulmonary hypertension group (PA group) and non pulmonary hypertension group (non PA group), according to the level of pulmonary artery pressure. The clinical data of patients' age and sex primary disease were collected. The blood routine, liver function, renal function, electrolytes, blood lipids, parathyroid hormone, etc. were detected. Cardiac color Doppler ultrasound was used to detect cardiac related indexes and pulmonary artery pressure. The serum levels of renal aminase and heart rate variability were measured, and the statistical analysis was carried out. Results The serum levels of renal aminase in PA groups were significantly lower than those in the non PA group (P＜005). The serum levels of renal aminase in all PA groups were significantly lower than those in the non PA group (P＜005). Association analysis showed that the level of serum renal aminase was negatively correlated with pulmonary hypertension. (r=019, P＜005). Renalase heart rate variability and correlation index (SDANN, SDNN, PNN50) were positively correlated (R = 0458, 0438, 0529, P＜005). Conclusion The renalase level is significantly reduced in maintenance hemodialysis patients. The renalase is negatively correlated with pulmonary artery pressure, but positively correlated with heart rate variability.