Involvement of aldosterone in left ventricular hypertrophy of patients with end-stage renal failure treated with hemodialysis

There is increasing evidence about important cardiovascular effects of aldo sterone through classic mineralocorticoid receptors in the heart. It is now clear that aldosterone/excess salt administration has been shown to produc e both cardiac hypertrophy and interstitial cardiac fibrosis in rats. In cl inical studies, it has been reported that aldosterone seems to play an impo rtant role in cardiac hypertrophy. However, it has still not been establish ed whether aldosterone is involved in cardiac hypertrophy in patients with end-stage renal failure treated with hemodialysis. In the present study, we have analyzed the association between cardiac hypertrophy and aldosterone in 29 patients (18 patients with nondiabetic nephropathy and 11 patients wi th diabetic nephropathy) who developed end-stage renal disease and received hemodialysis. Among the nondiabetic patients, left ventricular mass index correlated significantly with plasma aldosterone concentrations during both before and after hemodialysis, but it did not correlate with plasma renin activity. Furthermore, left ventricular mass index also correlated with mea n blood pressure. In contrast, these correlations were not seen in the diab etic patients, despite similar age distribution, duration of hemodialysis, and several echocardiographic parameters between two groups. In conclusion, our study provides new evidence for a relation between left ventricular hy pertrophy and plasma aldosterone concentrations that seems to be independen t of blood pressure in nondiabetic patients with endstage renal failure tre ated with hemodialysis. Am J Hypertens 1999;12:867-873 (C) 1999 American Jo urnal of Hypertension, Ltd.