Document Detail


Hemodialysis in hypotensive heart failure using midodrine.
MedLine Citation:
PMID:  19875951     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dialysis in patients with severe congestive heart failure and low blood pressure is difficult even in a hospital setting. We retrospectively recorded the effects and usefulness of an alpha (1) agonist in an outpatient dialysis unit in 5 patients with end-stage renal disease with symptomatic heart failure and low blood pressure. To provide outpatient dialysis, they were given midodrine before and during their dialysis sessions. METHODS: The volume of fluid removed, the lowest blood pressure, and postdialysis blood pressure measurements were recorded during a 3- to 4-week period just before initiating therapy (control period) and were compared with the measurements while using midodrine (treatment period). The blood pressures were expressed as the average of the mean arterial pressures (MAP). RESULTS: All patients had an increase in the lowest MAP during dialysis and in the postdialysis MAP. Each was significant at P = 0.03. Fluid removal was significant at P = 0.04. All the patients improved in their symptoms of orthopnea and shortness of breath. CONCLUSION: Outpatient dialysis is possible and relieves the symptoms of congestive heart failure in patients with poor heart function, low blood pressure, and advanced age when midodrine is given immediately before and during the procedure.
Authors:
Suzanne M Bergman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  338     ISSN:  1538-2990     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-17     Completed Date:  2010-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  470-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama 35294-007, USA. sbergman@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / therapeutic use*
Aged
Aged, 80 and over
Blood Pressure / drug effects
Female
Heart Failure / complications*,  drug therapy*
Humans
Hypotension / complications,  drug therapy*,  etiology*,  physiopathology
Kidney Failure, Chronic / complications*,  therapy*
Male
Middle Aged
Midodrine / therapeutic use*
Renal Dialysis / adverse effects*,  methods
Retrospective Studies
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 42794-76-3/Midodrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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