Pos-802 Control of Calcium and Phosphorus Metabolism Disorders in Hemodialysis Patients: Assessment of Adherence to Kdigo Recommendations

Abstract

symptomatic. Symptoms included cognitive decline/visual symptoms, optic ischaemic neuropathy/ auditory symptoms, nuchal pain & shoulder discomfort, instability whilst walking associated with a very high risk of falls & fracture, profound fatigue causing a state of marked dependency & house-bound for the most part of the inter-dialytic period. She received Midodrine 10 mg TDS, Fludrocortisone 100mcg & Erythropoietin.Droxidopa was commenced, in addition to other drugs, with 1 week of cardiac monitoring-No arrhythmias were recorded & LVOT gradient did not change at a dose of 400mg pre-dialysis at 0700 hours 3 times a week.The Orthostatic Hypotension Questionnaire (OHQ) was used to assess symptoms burden & severity of hypotension before commencing Droxidopa. Symptoms Diary was maintained by the patient throughout.Results: Table1 OHQ Scores Conclusions: Droxidopa 400 mg on dialysis days was well tolerated, achieved both symptomatic improvement & better blood pressure readings, both on HD & non-HD days during 4 months of follow up. Off label use can be considered in selected cases of difficult to manage hypotension in HD population, provided close & frequent monitoring can be offered.