Diagnostics and therapy of left ventricular hypertrophy in haemodialysis patients

Cardiovascular diseases present a leading cause of death in patients treated with haemodialysis. The rate of cardiovascular mortality in this population is approximately 9% on an annual basis, with left ventricular hypertrophy, ischemic heart diseases and heart failure having the highest rates of mortality. Left ventricular hypertrophy is present in 75-80 % of haemodialysis-treated patients. The most important risk factors for the progression of left ventricular hypertrophy are: hypertension, arteriosclerosis, secondary aortic stenosis, anaemia, increased volume of extracellular fluid and increased blood flow through the vascular access for haemodialysis. Left ventricular hypertrophy is present when the left ventricular mass index on echocardiography exceeds 131 g/m2 in males and 100 g/m2 in females. Left ventricular hypertrophy is a risk factor of unfavourable outcome in patients treated with haemodialysis. The identification of patients with increased risk of progression of left ventricular hypertrophy, the timely implementation of adequate treatment, and the realisation and maintenance of targeted values of risk factors decelerates the progression of the hypertrophy and leads to the regression of existing left ventricular hypertrophy, the reduction of cardiovascular morbidity and mortality rates and the improvement of the quality of life of patients treated with haemodialysis.