The correlative factors of left ventricular hypertrophy (LVH) in 287 end-stage renal disease (ESRD), admitted from 1983 to 1992, were analyzed. 52% of patients had LVH including 54% of patients on hemodialysis, 75% of patients with peritoneal dialysis and 38% of transplanted patients. Single factor analysis indicated that age, blood pressure, serum creatinine and BUN, hemoglobin, serum alkaline phosphatase, aortic valve disease and present DSRD therapy were related to LVH. Multiple logistic regression analysis indicated that the most important factors which independently related to LVH in all patients studied, were management of present ESRD treatment, age, hypertension and high serum alkaline phosphatase. In a subset of patients with severe LVH, high serum alkaline phosphatase level, high systolic blood pressure and age were the predictive factors. In patients on dialysis, the most important variable were age and high serum alkaline phosphatase. Hypertension was the sole predictor of LVH in the transplant group.