| IntroductionIt is known that the eighty percent of End Stage Renal Failure (ESRF) patients has various Cardiovascular Disease (CVD) which strongly affect the outcome of the patients. Further fifty percent to sixty - seven percent died of ESRF patients was due to Cardiovascular Disease . It is report that the abnormality of Cardiac structure and function mainly manifest as myocardium thickening,chamber volume enlarging ,systolic dysfunction and diastolic dysfunction . the remarkable feature of myocardium impairment in End Stage Renal Failure was left ventricular hypertrophy ( LVH) and left ventricular diastolic dysfunction (LVDDF) .The End - Stage - Renal - Failure patients mainly depend on renal replace therapy , that is using blood - purification ( BP) and renal transplantation to clear the uremia toxin. At present Hemodialysis ( HD) is most universal therapy mean . The ordinary hemodialysis technique is simplex, and its the effect of clearing uremia toxin is not affirmative , therefor various etiologies and complications correlated with hemodialysis were hardly improved and cured, online hemodiafil-tration (online HDF) , which was advocated in recent years , focusesadvantages of hemofiltration and hemodialysis . So many scholars have studied the effect of the clearing uremia toxin by blood purification ( BP) therapy . But the investigation is few about the effect of Blood purification( BP) on the myocardium structure and function in End Stage Renal Failure patients complicated by different etiology .As a result of the different cause of End Stage Renal Failure , abnormality of endo - environment and maladaptive compensation of various systems are dissimilar , therefor the myocardium impairment of the patients are different . Diabetic energy metabolism is abnormal , utilization and exchange of energy are disordered, the taking and utilization of the glucose and fatty acid are of impedient , synthesis of protein is decreasing , metabolism of enzyme is of confusion . myocardium involuntary nerves is in pathologic changes, myocardium adrener-gic innervation is abnormal, coronary artery is in pathologic changes with calcification and fatty deposit . the well - controlled Diabetes mellitus without complication company with left ventricular mass increase,left ventricular end - diastolic diameter enlargement and left ventricular diastolic dysfunction. . in hypertension patients the RAA system was stimulated. hypertension induce myocardium afterload increasing , rising Angiotension II ( Ang II) bring about left ventricular wall thickening and cardiac fibrosis which damage myocardium structure and function . hypertension is a independent risk factor correlated with left ventricular dilation,left ventricular hypertrophy and death in End-Stage-Renal-Failure patient . whatever it is physiologic or pathologic , left ventricular hypertrophy appears to be genetic , hormonal and hemodynamic stimulated.Doppler Ultraechocardiography (UCG) is easily performed , and noninvasive,safe,reproducible and accurate, It was conformed beinguseful and validly representation , which was used to assess the changes of the cardiac parameter after blood purification therapy and the correlation with improvement of the outcome .The purpose of this study was to explore the changes of the left ventricular structure and function in End Stage Renal Failure maintenance hemodialysis (MHD) patients complicated by different etiology ( Diabetic - Nephritis DN,Glomerulonephritis GN,Hypertension - Nephritis HN) and assess the effect of the online hemodiafiltration ( online HDF) and hemodialysis (HD) on the cardiac structure and function of the patients .Materials and Methods1. SUBJECTS:1. 1 Including criteria : ESRF : Ccr < 10ml/min,Scr 800-1500umol/L . ages: 40 - 65 years , stable hemodialysis more than three months , Diabetes Mellitus patients: blood glucose ( before meal) <8mmol/L,blood glucose (after meal) < 14mmol/L.Excluding criteria: valvular heart disease, uncontrolled hypertension , hypotension , acute h...
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