The Effect of Midodrine Hydrochloride on Chronic Hypotension in Patients with Diabetes Mellitus Undergoing Hemodialysis Therapy

Abstract

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: Chro nic hypo ten si on is a com mon comp li ca ti on of he mo di aly sis in pa ti ents with di a be tes mel li tus. Mi dod ri ne hydroch lo ri de is an alp ha-1 ago nist that ef fec ti vely cor rects intra di aly tic hypo ten si ve at tacks. However, the ef fect of mi dod ri ne on chro nic hypo ten si on is still unk nown in he mo di aly sis pa ti ents. In the pre sent study, we ai med to eva lu a te the ef fects of mi dod ri ne tre at ment on chro nic hypo ten si on in pa ti ents with di a be tes mel li tus undergoing he mo di aly sis. M Ma a--t te e r ri i a al l a an nd d M Me et t h ho od ds s: A to tal of 21 di a be tic pa ti ents un der go ing he mo di aly sis and had chro nic hypo ten si on (systo lic blo od pres su re <100 mmHg be fo re di aly sis) we re inc lu ded in the study. Mi dod ri ne was given 5 mg p.o. twi ce a day and 5 mg be fo re every di aly sis ses si on to all pa ti ents. Blo od pres su res (pre-he mo di aly sis systo lic, di as to lic and me an ar te ri al pres su re) we re me a su red. In tra-di aly tic hypo ten si on at tacks, ort hos ta sis, diz zi ness, fa ti gu e, blur red vi si on, dull ness, and he a dac he we re re cor ded. Da ta ob ta i ned be fo re mi dod ri ne the rapy we re com pa red to tho se collec ted at the 3 rd month of he mo di aly sis when the patients were under mi dod ri ne the rapy. R Re e s su ul lt ts s: : Pre-di aly sis systo lic, di as to lic and me an ar te ri al blo od pres su res, ver ti go and synco pe at tacks were sig ni fi cantly (p< 0.05) im pro ved by mi dod ri ne the rapy. No sig ni fi cant dif fe ren ce was se en in mean ul tra-fil tra ti on vo lu me per he mo di aly sis ses si on and num ber of in tra-di aly tic hypo ten si ve at tacks ac cor ding to ba se li ne va lu es over the co ur se of study (p>0.05). C Co on nc c l lu u s si i o on n: : Mi dod ri ne ap pe ars to be an ef fec ti ve and sa fe tre at ment op ti on in di a be tic he mo di aly sis pa ti ents with sympto ma tic chro nic hypo ten si on, but it has no ef fect on in tra-di aly tic hypo ten si ve at tacks. K Ke ey y W Wo or rd ds s: : Di a be tes mel li tus; hypo ten si on; re nal di aly sis; Mi dod ri ne Ö ÖZ ZE ET T A Am ma aç ç: Kro nik hi po tan si yon di ya bet li has ta lar da he mo di ya li zin sık gö rü len bir komp li kasyo nu dur. Mi dod rin hid rok lo rid di ya liz sı ra sın da ki hi po tan sif atak la rı et ki li şekil de dü zel ten al fa-1 ago nist bir ilaç tır. Fa kat he mo di ya liz has ta la rın da mi dod ri nin kro nik hi po tan si yon da ki et ki si ha len bi lin me mek te dir. Bu ça lış ma da mi dod rin te da vi si nin he mo di ya liz te da vi si alan di ya bet has ta la rın -da kro nik hi po tan si yo na et ki le ri ni de ğer len dir me yi amaç la dık. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: Kro nik hi potan si yo nu olup (di ya liz den ön ce sis to lik kan ba sın cı <100 mmHg) he mo di ya liz te da vi si alan top lam 21 di ya be tik has ta ça lış ma ya alın dı. Tüm has ta la ra gün de iki kez ...

Pretransplant Midodrine Use

“…A more recent study including 21 diabetic patients with chronic hypotension defined as systolic blood pressure less than 100 mmHg before dialysis found that midodrine therapy was associated with 10 mmHg and 5 mmHg increases in systolic and diastolic blood pressure, respectively. Vertigo and syncope significantly improved with midodrine therapy 26 . Again, no substantial side effects were noted.…”

“…Despite these observations of the safety of midodrine in the dialysis population 13,26 , intradialytic hypotension remains a significant risk factor for mortality among ESRD patients 1819 . The present study advances knowledge of the outcome implications of symptomatic hypotension by identifying pretransplant midodrine use, a measure of clinically significant hypotension, as a risk marker for complications after kidney transplantation.…”