Interleukin-10 (IL-10) predominantly acts as an anti-inflammatory factor. Polymorphisms in the IL-10 gene promoter determine quantitative cytokine production. Doppler echocardiography and tissue Doppler imaging (TDI) are superior to conventional echocardiography to evaluate diastolic dysfunction. The IL-10 gene promoter polymorphism at position (-1082) was studied for its association with conventional and Doppler echocardiographic and TDI parameters in 112 hemodialysis (HD) patients. Blood pressure, serum C-reactive protein (CRP), and albumin levels were also examined for the association study. The genetic association study showed that among the HD patients, there was no difference in the prevalence of systolic and diastolic dysfunction between genotypes on conventional echocardiography. However, using Doppler echocardiography and TDI, high producers for the IL-10 -1082 promoter (-1082/GG) have higher E velocities, E/A values, lateral, and septal E' velocities and a lower isovolumic ventricular relaxation time than low (-1082/AA) and intermediate producers (-1082/GA). Significantly higher levels of serum CRP levels and lower plasma albumin levels were found in low and intermediate producers for the IL-10 -1082 promoter than high producers. The IL-10 genotype may balance the effects of inflammatory cytokines on the myocardium and may be a determinant of LV function in HD patients.