Background <p>Cardiovascular diseases are the most frequent causes of death in patients with chronic kidney disease. Patients with chronic kidney disease often have heart remodeling with left ventricular hypertrophy, left atrial enlargement, and diastolic and systolic dysfunction which reverse after kidney transplantation. Since sex hormones modulate heart histology and physiology, this study aims to know whether the remodeling changes of the heart after a kidney transplant according to sex.</p> Methods <p>A prospective study was carried in recipients of a kidney graft followed-up from transplant to three and six months after. Biochemical and echocardiographic parameters were obtained and differences between sexes analyzed. The comparison of the studied parameters was made by two way ANOVA considering sex and months of follow-up. A value of <i>p</i> &lt; 0.05 was considered significant.</p> Results <p>Fifty-one patients were studied, 19 women and 32 men (mean age 31.16 ± 9.83 vs. 31.66 ± 9.63 years, p 0.86). The Left ventricular hypertrophy showed differences according to sex at baseline, men had higher left ventricular mass index than women (male 152.94 ± 58.24 Vs. women 103.89 ± 29.94&#xa0;g/m2, <i>p</i> = 0.000), as well as during follow-up. Men had a more significant reduction in the left ventricular mass index compared to women (<i>p</i> = 0.000). The left atrial volume index was found to be langer at baseline in women compared to men (45.18 ± 29.77 Vs. 29.05 ± 9.30&#xa0;ml/m2, <i>p</i> = 0.028). At follow-up, the size reduction was more significant in women (<i>p</i> = 0.000).</p> Conclusion <p>There was a difference in cardiac remodeling after renal transplant according to sex.</p>