Abstract: Objective To investigate the effects of renal dysfunction (RD) on heart rate variability (HRV) of patients with coronary heart disease (CHD). Methods Two hundred consecutive patients with CHD admitted to Chinese PLA General Hospital from June 2014 to June 2015 were divided into CHD alone group (n=130) and CHD with RD group (n=70).Healthy subjects were selected as control group (n=70).The heart rate of cases in three groups was monitored by 24h Holter, and parameters related to HRV standard deviation of NN intervals (SDNN), standard deviation of the average NN intervals (SDANN), average of the standard deviation NN interval (ASDNN) were measured and analyzed in three groups. Results The SDNN, SDANN and ASDNN of three groups were (139±30) ms, (129±22) ms and (89±17) ms in control group; (127±25) ms, (115±20) ms, (70±14) ms in CHD group; (100±19) ms, (93±12) ms, (52±15) ms in CHD with RD group.HRV parameters of CHD group were significantly lower than control group (P< 0.05), while it was significantly lower in CHD with RD group when compared with the other two groups (P< 0.05). Conclusion RD can exacerbate HRV decreasing in CHD patients and may also forecast poor prognosis.