Left ventricular hypertrophy: why does it happen?

Patients with end-stage renal disease (ESRD) have much higher rates of cardiovascular disease than the healthy population. Left ventricular hypertrophy (LVH), in particular, is common in this patient group. The impact of a decline in haemoglobin concentration on left ventricular mass index has been well documented. Partial correction of anaemia with recombinant human erythropoietin (epoetin) treatment has been recognized as a significant step forward in decreasing left ventricular mass and improving cardiovascular morbidity and mortality. However, LVH and cardiac failure in patients with ESRD comprise a complex condition, which is influenced by a number of factors in addition to anaemia. This article examines some of the pathophysiological aspects of LVH in patients with ESRD.