Mortality among patients with ESRD remains high because of an excessive cardiovascular risk related to a very high incidence of cardiac hypertrophy, cardiomyopathy, heart failure, and coronary artery disease. Identifying serum biomarkers that are useful in profiling cardiovascular risk and enabling stratification of early mortality and cardiovascular risk is an important goal in the treatment of these patients. This review examines current evidence pertaining to the role and utility of two emerging cardiac biomarkers, B-type natriuretic peptide and cardiac troponin T, in patients with ESRD. Together, these data demonstrate how these two cardiac biomarkers may play an adjunctive role to echocardiography in assessing cardiovascular risk and how they may aid in the clinical treatment of these patients.