[Left ventricular hypertrophy in patient on dialysis]

Left ventricular hypertrophy (LVH) is a significant factor for higher mortality caused by cardiovascular diseases, which are the main cause of death (45%) in hemodialysis patients. In this study we analyzed the link between hypertension nad anemia, which are the main risk factors for the occurrence of LVH. The study included 40 patients (20 M and 20 F, age 20-80 years) who were treated with chronic dialysis. Using the method of transthoracic echocardiography, in M-mode, 38 patients underwent measurement of the thickness of intraventricular septum and posterior wall of the left ventricle at the end of diastole. LVH was expressed through the left ventricle mass index (LVMI) > 131 g/m2 for male and > 100 g/m2 for female. The efficiency of dialysis was calculated with the standard formula (Kt/V1,2). The patients on erythropoietin therapy received medium maintenance dose of 4000 units per week. Blood pressure and hemoglobin data were included in the calculations. A statistically higher rate of hypertension was found in males (M 17/20, F 10/20, p = 0.04), and of myocardial hypertrophy in females (M 7/20, F 17/20, p = 0.004). Overall patient data analysis showed LMVI to be statistically significantly higher (p = 0.0004) in hypertensive patients, and so were the values of systolic and diastolic pressure (p = 0.0006) in spite of applied medication. Hemoglobin was significantly higher (p = 0.04) in LVH patients. A significant positive correlation was found between LVMI and arterial pressure (p = 0.006), and negative between LVMI and hemoglobin concentration (p = 0.03). There was no statistically significant correlation between LVMI and age, interdialytic fluid intake and Kt/V. These results indicate that among patients on chronic dialysis treatment, LVH is more frequent in those with hypertension. The higher hemoglobin concentration found in patients with LVH was probably due to the relatively small number of patients. It is necessary to reduce the effect of risk factors for LVH by using better therapeutic options, thus to decrease the mortality in dialysis patients.