Objective To discuss the situation of autonomic neuropathy in the patients with chronic renal failure (CRF) by Heart Rate variability(HRV). Methods HRV were studied by 24-hour Holter in 20 healthy people for control,77 patients with CRF (30 patients with azotemia and 47 patients with uremia). Results HRV in CRF group was significantly lower than in control group.SDNN (85.28±19.96),SDANN Index (75.55±22.47),r-MSSD (19.22±11.82),PNN 50 (6.7±14.79) (P<0.01).There is no significant difference between azotemia and uremia. Conclusion There was dysfunction of autonomic neuropathy in the patients with chronic renal failure.By the HRV analysis we found that HRV was decreased in the azotemia patient,which suggested that there was autonomic neuropathy lesion in the early stage of CRF.