Left ventricular hypertrophy in daily dialysis

Cardiac hypertrophy, a well-known independent risk factor for cardiovascula r death, is a very frequent complication in ESRD patients. Its frequency te nds to be even higher in dialyzed patients due to the fact that the current dialytic treatments are unable to keep under a satisfactory control the va rious responsible factors and particularly the blood pressure, which is lar gely the most important. Daily hemodialysis, a more frequent schedule consi sting of 6-7 sessions/week lasting 2 or more hours, has definitely proved i ts superiority in controlling blood pressure and in improving anemia, and t hus has the requisites for positively influencing cardiac hypertrophy. In f act, a series of studies, both retrospective and prospective, performed dur ing the last years by our group, have confirmed that this new, more frequen t and thus more physiological schedule, is able not only to stop the progre ssion of the cardiac hypertrophy in uremic patients but also to revert towa rd the normality, in a relatively short time. This appears to be essentiall y a consequence of the excellent blood pressure control, which in turn deri ves from the easier control of the true dry weight, achievable with this ty pe of dialytic treatment.