Effect of mineralocorticoids on interdialytic weight gain in hemodialysis patients with perdialytic hypotension.

Abstract

Fludrocortisone is recommended in patients with orthostatic hypotension and a benefit has been suggested in hemodialysis patients with severe hypokaliemia. We report 2 patients who suffered from chronic severe perdialytic hypotension resistant to midodrine and who were treated in a long-term period with fludrocortisone. A rise of post-dialytic BP was observed with a decrease of the interdialytic weight gain (IWG). We suggest that the IWG decrease is induced by a lessening of the renin angiotensin aldosterone system that could be less stimulated at the end of the dialysis session because of a better-preserved arterial pressure. The decrease of angiotensin could lessen the feeling of thirst.

• Authors: Lucile Mercadal, Thierry Petitclerc
• Journal: Hemodialysis international. International Symposium on Home Hemodialysis (Hemodial Int) Vol. 9 Issue 4 Pg. 338-40 (Oct 2005) ISSN: 1492-7535 [Print] Canada
• PMID: 16219052 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenergic alpha-Agonists
• Anti-Inflammatory Agents
• Midodrine
• Fludrocortisone

Topics

• Adrenergic alpha-Agonists (administration & dosage)
• Aged
• Anti-Inflammatory Agents
• Blood Pressure
• Drug Resistance (drug effects)
• Female
• Fludrocortisone
• Humans
• Hypokalemia (complications, physiopathology, therapy)
• Hypotension (drug therapy, etiology, physiopathology)
• Male
• Middle Aged
• Midodrine (administration & dosage)
• Renal Dialysis (adverse effects, methods)
• Renin-Angiotensin System (drug effects)