Background <p>The Dickkopf wingless (Wnt/β-katenin) signalling pathway is a significant signalling network for cardiovascular diseases.</p> Objective <p>The aim of our study was to investigate the relationship between sclerostin and left ventricular (LV) mass index (LVMI), as well as LVH, in predialysis CKD patients.</p> Methods <p>The study included 282 stage 3–5 predialysis CKD patients. Renal functions were determined by spot urine protein/creatinine ratio (SUPC) and estimated glomerular filtration rate (eGFR). Echocardiography was used to calculate LV ejection fraction (LVEF), left atrium diameter (LAD), LV end-diastolic diameter (LVEDD), and LV end-systolic diameter (LVESD.</p> Results <p>In the patients, increased SUPC, sclerostin, LAD, LVMI, LVH, and decreased eGFR and LVEF were observed compared to healthy individuals. In correlation analysis, a significant positive correlation was found between log₁₀ sclerostin and LVMI, as well as LVH, while an inverse relationship was observed with eGFR.</p> Conclusion <p>Increased sclerostin levels and development of LVH were observed in stage 3–5 pre-dialysis CKD patients compared to healthy individuals. An inverse relationship was found between sclerostin and eGFR, and significant relationships were observed with LVMI and LVH. Elevated sclerostin levels in pre-dialysis CKD patients may induce cardiac myocyte hypertrophy through an unknown receptor or mechanism.</p>