title: The clinical course of left ventricular hypertrophy in dialysis patients.
abstract: To determine the clinical and echocardiographic outcome of left ventricular hypertrophy a prospective study was undertaken of 104 nondiabetic dialysis patients without dilated cardiomyopathy, who were followed for 3-5 years. 33% of patients had normal echocardiogram, 41% mild and 27% severe hypertrophy (left ventricular wall thickness greater than or equal to 1.4 cm in diastole). In the first 2 groups 16% progressed to severe hypertrophy, 23% were admitted with congestive heart failure after starting dialysis therapy, and 2-year cumulative survivals were 97 and 85%. In the group with severe hypertrophy 88% already had severe hypertrophy on starting dialysis therapy, it was persistent in 87%, 50% were admitted at least once with congestive heart failure, and the 2-year cumulative survival was 53%. 71% of those who died in the severe group died from cardiac or cerebrovascular causes compared to none of those with normal echocardiogram, which accounted for the significantly worse (p = 0.001) survival. We conclude that severe left ventricular hypertrophy occurs frequently in dialysis patients, is often present at the start of end-stage renal disease therapy, is persistent, may predispose to congestive heart failure, and is associated with a high mortality.
authors: Division of Nephrology, Memorial University of Newfoundland, St. John's.
authors: P S
authors: PS
authors: Parfrey
authors: J D
authors: JD
authors: Harnett
authors: S M
authors: SM
authors: Griffiths
authors: R
authors: R
authors: Taylor
authors: J
authors: J
authors: Hand
authors: A
authors: A
authors: King
authors: P E
authors: PE
authors: Barre
mesh_terms: D006332:Cardiomegaly / Q000175:diagnosis / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors