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| |  ERA-EDTA: Regression of Left Ventricular Hypertrophy Possible in Haemodialysis Patients By Lynda Jackson COPENHAGEN, DENMARK -- July 18, 2002 -- For the first time, researchers have shown that marked improvement and even complete normalisation of left ventricular hypertrophy (LVH) is possible in haemodialysis patients. In haemodialysis patients numerous factors often lead to left ventricular hypertrophy and therefore influence the prognosis. Some of the known factors are hypervolaemia, arterial hypertension, severe metabolic acidosis, renal anaemia, severe hyperparathyroidism, oxidation of the sympathetic tone, and activation of the rennin angiotensin aldosterone system. To determine whether LVH could be reversed in haemodialysis patients, Dr. H. Hampl and colleagues from the department nephrology at Charité Campus Virchow-Klinikum, and the intensive care medicine unit at Virchow-Klinikum, in Berlin, Germany, enrolled 50 women and 50 men who had undergone haemodialysis for about 14 years. Treatment involved correction of metabolic acidosis, control of hydration, hypervolaemia and hyperparathyroidism, complete correction of renal anaemia, aggressive antihypertensive treatment with beta-blockers and angiotensin converting enzyme inhibitors in combination with angiotensin II receptor antagonists. The results of this study were presented here July 17 at the XXXIX Congress of the European Renal Association, European Dialysis and Transplant Association (ERA-EDTA). The researchers used serial echocardiography to obtain left ventricular mass index (LVMI) for each patient as a marker of LVH. After a mean follow-up period of 18 months, the researchers identified four groups: Group A - 36 percent of patients initially presented with normal LVMI and remained normal 102±13 vs. 93±21 p<0.004. Group B - 31 percent of patients had markedly elevated LVMI that was reversed to normal 162±33 vs. 108±11 p<0.0000001. Group C - 22 percent of patients improved their LVMI but did not reach normal levels. Group D - 11 percent of patients did not improve and remained therapeutically resistant (197±36 vs. 199±41). These patients had severe heart diseases that were often combined with ischaemic heart- and valve disease and end stage dilatative cardiomyopathy, and required cardiac surgery. The researchers concluded that it is possible to achieve complete normalisation or marked improvement of left ventricular hypertrophy in patients being treated with haemodialysis.
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