Echocardiographic evaluation of cardiac size and function in dialysis patients

M-mode echocardiography was performed on 43 maintenance hemodialysis patients and 3 patients on continuous ambulatory peritoneal dialysis (CAPD). Only seven patients had completely normal echocardiograms. Nine patients (20%) had pericardial effusions and 20 patients (44%) had left ventricular dilatation. Left ventricular hypertrophy was present in 26 patients (57%): in 18 patients this took the form of concentric hypertrophy and in 8 patients there was asymmetric septal hypertrophy. Left ventricular function was depressed in 12 patients (27%). Left ventricular dilatation was more common in patients with multiple vascular accesses, who also tended to have lower hematocrit values. Left ventricular hypertrophy tended to be more common in patients with prolonged hypertension and with excessive inter-dialytic weight gains. Younger patients and those who had been on dialysis for a longer period had less cardiac abnormalities, suggesting that chronic dialysis might reverse these changes. Echocardiography was more sensitive than chest X-ray and ECG in detecting clinically unsuspected abnormalities and provides useful information in the overall evaluation of maintenance dialysis patients.