Chronic kidney disease (CKD) is associated with a high risk of death and morbidity due to cardiovascular disease. Much of this is caused by left ventricular disease characterised by abnormal muscle thickness and scaring. This process appears to start early in the course of CKD and causes heart failure and dangerous abnormal heart rhythms. Previous work suggests that the process may be reversible by kidney transplantation but almost all of the studies are small, retrospective and lack scientific rigour. Furthermore, they almost all use echocardiography, which is inaccurate in patients with CKD. The investigators plan to perform the first large, prospective, controlled, blind-analysed study using cardiac magnetic resonance imaging to determine whether CKD associated cardiomyopathy is reversed by kidney transplantation and if so, whether factors such as blood pressure and mediators of metabolic bone disease/fibrosis are important in effecting this change. Greater understanding of the mechanisms responsible for CKD associated cardiomyopathy could lead to future strategies and treatments to improve the high cardiovascular mortality associated with this condition.

Inclusion Criteria:

1. Patients registered on the kidney transplant waiting list at the University Hospital Birmingham NHS Foundation Trust.
2. Ages over 18 years

Exclusion Criteria

1. Non-standard anti-rejection treatment, post transplant.
2. Previous history of being unable to tolerate MRI scanner.
3. Contraindication to MRI - eg metal fragments in ey

The study population will comprise of patients with end-stage renal failure currently awaiting either live or deceased donor transplantation.