The effects of Midodrine treatment in patients with hemodialysis-related hypotension

Objective To study the effect of midodrine to prevent the hemodialysis-related hypotension(IDH) in maintained-hemodialysis(MHD) patients.Methods 27 MHD patients who had usually showed IDH were involved.These patients received hemodialysis with the same hemodialysis prescription,but took orally Midodrine 7.5～15mg for three times every day,and took orally another 5mg at 30 minutes before hemodialysis or onset of IDH.Blood pressure and IDH were observed during hemodialysis.Results Ultrafiltration rate,pre-hemodialysis blood pressure,temperature and sodium concentration of dialysate were no significant difference between before and after Midodrine treatment in 27 cases(P 0.05).After Midodrine treatment,total ultrafiltrated volumes,the lowest intrahemodialysis blood pressure,and post-hemodialysis blood pressure were increased significantly(P0.05),and the cases showed IDH,symptomatic IDH were reduced(P 0.01).Midodrine treatment showed significant effect in 11 cases(40.7%),showed effect in 9(33.3%),and showed no effect in 7(26.0%).Conclusion We suggest that Midodrine treatment can effectively prevent hemodialysis-related hypotension in MHD patients.