Pharmacologic options available to treat symptomatic intradialytic hypotension

被引:48
作者
Perazella, MA [1 ]
机构
[1] Yale Univ, Sch Med, Nephrol Sect, New Haven, CT 06520 USA
关键词
hypotension; hemodialysis (HD); midodrine; end-stage renal disease (ESRD); diabetes mellitus; cardiomyopathy; neuropathy;
D O I
10.1053/ajkd.2001.28092
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Treatment of symptomatic intradialytic hypotension (IDH) is a difficult task for the practicing nephrologist. Minimizing patient factors that precipitate IDH as well as dialysis procedure-related components that lower blood pressure are the initial approaches to this problem. However, despite these maneuvers, hypotension often persists in a group of high-risk patients. Pharmacologic interventions are often used to reduce IDH. Unfortunately, many of the available therapies are marginally effective and/or poorly tolerated. A few therapies appear to be efficacious and well tolerated-carnitine, sertraline, and midodrine. This article reviews the various pharmacologic therapies used for IDH and makes recommendations for treatment of this difficult problem. (C) 2001 by the National Kidney Foundation, Inc.
引用
收藏
页码:S26 / S36
页数:11
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