UNLABELLED Cardiovascular diseases are the major cause of mortality in uraemic patients treated by hemodialysis. Left ventricular hypertrophy (LVH) is considered to be a major cardiac risk factor. AIM To investigate the presence of some potential adverse risk factors in hemodialysis patients with developed LVH echocardiography verified and determine their relative contribution to the LVH in comparison with patients with normal LV. METHOD The study included 50 patients with end-stage renal disease in the first 2 years of hemodialysis treatment, who were followed up during one year. All participants have the echocardiography performed as well as serial measurements of potential modifiable cardiovascular risk factors. RESULTS This investigation showed that LVH is present in high percentage (72%) in uraemic patients, even at the beginning of hemodialysis treatment. This LV morphological abnormality is statistically significantly related to anaemia (p<0,001), systolic (p<0,001) and diastolic hypertension (p<0,001)), elevated mean arterial pressure (p<0,001) and hyperparathyroidism (p=0,002). CONCLUSION Modification of existing risk factors in uraemic patients could contribute to prevention and treatment of LV hypertophy and thus reduce cardiovascular morbidity and mortality.

INTRODUCTION Anemia has been shown to be a key component of renal failure, as well as of the occurrence of left ventricular hypertrophy (LVH), with special attention paid to the paracrine mechanism of left ventricular remodelling. AIM The aim of the study was to analyze possible association of serum angiotensin-converting enzyme (ACE) activity and LVH in hemodialysis patients with anemia treated with human recombinant erythropoietin (rHuEpo) during six months. METHOD LV geometry was determined by echocardiographic analysis in 20 hemodialysis patients before and after erythropoietin treatment. Serum ACE activity was measured by spectrophotometric method using hippyril-l-histidyl-l-leucin as a substrate. RESULTS Serum ACE activity increased to 47.3% in hemodialysis patients with LVH as compared to patients with normal LV mass. A significant positive correlation was found between the level of ACE activity and LV mass index (p=0.004). Six-month erythropoietin treatment of anemia led to a significant reduction of LV mass index (p<0.008) and serum ACE activity (p=0.003) from the initial values. CONCLUSION The levels of serum ACE activity are associated with LV geometry. Our findings suggested the possibility of simultaneous and modest modulation of LV mass and serum ACE activity with rHuEpo correction of renal anemia.