Objective: Retrospective study was conducted on 96 end-stage renal disease patients with HD. All patients underwent echocardiography and Bioelectrical Impedance Analysis (BIA) after a post HD session. Overhydration (OH) was measured by BIA. Serum NT-proBNP was measured after HD. Methods: There was an inverse correlation between NT-proBNP and ejection fraction (EF) (β =  -0.34, p = 0.001). OH (β = 0.33, p = 0.001) and presence of diastolic dysfunction (β = 0.226, p = 0.027) had positive correlations with NT-proBNP. In the subgroup analysis with diastolic dysfunction grade, NT-proBNP increased as the dysfunction grade increased. (diastolic dysfunction grade 0; 4177 [2637 - 10391], grade 1; 9736 [5471 - 21110], grade 2,3; 24627 [16975 - 44988], interquartile range) Elevation of NT-proBNP above 11576 pg/ml was associated with the presence of diastolic dysfunction (P < 0.001), left ventricular hypertrophy (LVH) (p < 0.001) as well as EF<55% (p = 0.07). 'lowered dry weight' group followed up NT-proBNP one month later compared to 'no change in dry weight' group. NT-proBNP showed a tendency to decrease in 'lowered dry weight' group, and 'no change in dry weight' group showed a relatively low level of NT-proBNP variability. (delta NT-proBNP; -210 [-12899 - 3142] vs 330 [-1090 - 3858]; interquartile range, p = 0.104) Results: We confirmed that NT-proBNP is associated with volume status as well as heart functions such as diastolic dysfunction, EF and LVH in HD patients. Conclusions: Objective: N-terminal pro brain natriuretic peptide (NT-proBNP) is a biomarker that predicts heart failure and evaluates volume status in Hemodialysis (HD) patients. However, it is difficult to determine the cutoff value of NT-proBNP in HD patients. In this study, we analyzed whether NT-proBNP helps with predicting heart function and volume status in HD patients. Methods: Retrospective study was conducted on 96 end-stage renal disease patients with HD. All patients underwent echocardiography and Bioelectrical Impedance Analysis (BIA) after a post HD session. Overhydration (OH) was measured by BIA. Serum NT-proBNP was measured after HD. Results: There was an inverse correlation between NT-proBNP and ejection fraction (EF) (β =  -0.34, p = 0.001). OH (β = 0.33, p = 0.001) and presence of diastolic dysfunction (β = 0.226, p = 0.027) had positive correlations with NT-proBNP. In the subgroup analysis with diastolic dysfunction grade, NT-proBNP increased as the dysfunction grade increased. (diastolic dysfunction grade 0; 4177 [2637 - 10391], grade 1; 9736 [5471 - 21110], grade 2,3; 24627 [16975 - 44988], interquartile range) Elevation of NT-proBNP above 11576 pg/ml was associated with the presence of diastolic dysfunction (P < 0.001), left ventricular hypertrophy (LVH) (p < 0.001) as well as EF<55% (p = 0.07). 'lowered dry weight' group followed up NT-proBNP one month later compared to 'no change in dry weight' group. NT-proBNP showed a tendency to decrease in 'lowered dry weight' group, and 'no change in dry weight' group showed a relatively low level of NT-proBNP variability. (delta NT-proBNP; -210 [-12899 - 3142] vs 330 [-1090 - 3858]; interquartile range, p = 0.104) Conclusions: We confirmed that NT-proBNP is associated with volume status as well as heart functions such as diastolic dysfunction, EF and LVH in HD patients.