To elucidate the differences in the left ventricular diastolic function between patients on maintenance hemodialysis with left ventricular hypertrophy and the those with left ventricular hypertrophy from other causes, 20 patients on maintenance hemodialysis (HD group; mean age 44 +/- 12 years), 12 patients with hypertensive heart disease (HHD group; mean age 43 +/- 10 years), and 10 patients with hypertrophic cardiomyopathy (HCM group; mean age 43 +/- 11 years) were examined non-invasively using diastolic time intervals and digitized echocardiograms. Ten age-matched healthy men (N group; mean age 43 +/- 12 years) were also examined. Compared with the HCM group, the HD and HHD groups had a decreased total left ventricular wall thickness and left atrial dimension, an increased ratio between the left ventricular enddiastolic dimension and total left ventricular wall thickness. The isovolumic relaxation and rapid relaxation periods were prolonged in the order of HCM, HHD, HD and N, but the active suction period was prolonged only in the HCM group. The peak rate of change in the left ventricular dimension during the rapid filling period was decreased in the HCM group, compared with the HD and the HHD groups. These results indicate that hemodialysis patients with left ventricular hypertrophy have some impairment in left ventricular diastolic function, but the degree of the disturbance is similar to that observed in those with hypertensive heart disease, but milder than that observed in those with hypertrophic cardiomyopathy.