Efecto de la midodrina en la hipotensión sintomática en hemodiálisis / Effects of midodrine on orthostatic hypotension during hemodialysis

RESUMO

Background: Hypotension occurs in 20 percent of hemodialysis procedures. Aim: To study the effects of midodrine on hypotension during hemodialysis. Patients and methods: Ten patients on chronic hemodialysis and with a history of hypotension during the procedure, were studied. They received midodrine 10 mg per os or placebo during 5 dialytic procedures each, in a double blind cross over design. Results: Blood pressure levels prior to dialysis were similar during the midodrine or placebo administration periods. During dialysis, systolic blood pressure fell 19.3ñ28 mmHg with midodrine and 23.4ñ28 mmHg with placebo. Diastolic blood pressure fell 7.3ñ11.5 mmHg with midodrine and 11.1ñ12 mmHg with placebo. The reduction in median arterial pressure was also less pronounced with midodrine. Conclusions: Midodrine lessens the fall in arterial pressure during hemodialysis, in patients with symptomatic hypotension