We designed this study to compare serum markers of myocardial injury creatine kinase MB (CK-MB), as well, as serum contractile proteins, especially cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in dialysis patients without acute ischemic heart disease. 24 patients on chronic hemodialysis were studied by history and physical examination, electrocardiography, and two-dimensional echocardiography. These patients had no evidence of ischemic heart disease. Biochemical markers were measured in serial predialysis blood samples with specific monoclonal antibody-based immunoassays. For several patients at least one sample measured above the upper reference limit: CK-MB, 7 of 24 (30%); ELISA cTnT, 17 of 24 (71%); Enzymun cTnT, 3 of 18 (17%); and cTnI, 1 of 24 (4%). Chronic dialysis patients without acute ischemic heart disease frequently had increased serum CK-MB and cTnT. Our finding are in agreement with the conclusions that cTnT and CK-MB detected in the serum of patients on chronic hemodialysis originates from the skeletal muscle and not from the heart.