Prevention of cardiac morbidity and mortality in uremics: therapeutic strategies with especially attention to complete correction of renal anemia

Left ventricular hypertrophy and cardiac dysfunction vary broadly in end-st age renal patients and are important determinants of quality of life and su rvival. The pathogenesis of left ventricular hypertrophy is discussed. The multifactorial causes of uremia-associated left ventricular hypertrophy off er various therapeutic options: optimal control of arterial hypertension an d volume status, optimal correction of metabolic acidosis, use of angiotens in-converting enzyme inhibitors or angiotensin II receptor blockers and P-b lockers and complete correction of renal anemia. Following the proposed the rapeutic strategies we have achieved normalization of the left ventricular mass index (LVMI), a predictor of mortality in the dialysis population, in 15 dialysis patients for present. The normal availability of oxygen by comp lete correction of renal anemia has one of the most important cardioprotect ive impacts in our patients.