Aim. To investigate abnormalities in myocardial strain and classic echocardiographic indices and coronary flow reserve (CFR), in younger vs older CKD patients. Methods. Sixty consecutive CKD patients (<60 years old n=30, ≥60 years old n=30) and 30 healthy controls (age- and gender-matched with younger CKD patients) were recruited. An echocardiographic assessment including myocardial strain indices was performed at baseline and following dipyridamole administration in all participants. Results. Younger CKD patients had higher E/e’, left ventricular mass index and relative wall thickness and lower E’ (p<0.005 for all) compared to healthy controls. Older CKD patients had lower E/A and E’ (p<0.05 for both) compared to younger CKD patients; these differences did not remain significant after adjustment for age. CFR was higher in healthy controls compared to younger and older CKD patients (p<0.05 for both) without a significant difference between CKD groups. Dipyridamole-induced changes did not differ significantly among the 3 groups. Conclusions. Compared to healthy controls, impaired coronary microcirculation and left ventricular diastolic function, but not myocardial strain abnormalities, are found in young CKD patients and deteriorate with aging.