In the contemporary diagnostics of myocardial infarction importance of the role of biochemical markers such as troponins, CK, CK-MB, CK-MB mass has been underscored. In the paper biochemical aspects of their composition and the kinetics of troponin realase by the heart have been presented. Frequent occurrence of cardiovascular diseases in population of patients with chronic kidney disease, being the results of coexistence of traditional and non-traditional risk factors, has been highlighted. Also, difficulties in diagnostics of acute coronary symptoms in this group of patients have been pointed to. In the article the factors leading to non- specific elevation of serum troponin levels in this patient population, as well as the influence of the degree of kidney function impairment and influence of the type of dialysis on troponin levels have been discussed. Based on the analysis of the major clinical trials the role of troponin in diagnostics of myocardial infarction and long-term prognosis in patients with chronic kidney disease have been discussed. Other clinical conditions in which serum troponin level elevation is observed have been although discussed.