2001
Pharmacologic options available to treat symptomatic intradialytic hypotension
Perazella M. Pharmacologic options available to treat symptomatic intradialytic hypotension. American Journal Of Kidney Diseases 2001, 38: s26-s36. PMID: 11602458, DOI: 10.1053/ajkd.2001.28092.Peer-Reviewed Original ResearchConceptsSymptomatic intradialytic hypotensionIntradialytic hypotensionHigh-risk patientsLower blood pressurePharmacologic optionsPharmacologic therapyBlood pressurePatient factorsAvailable therapiesPharmacologic interventionsHypotensionTherapyTreatmentInitial approachMidodrineNephrologistsPatientsSertralineTreatment of Severe Intradialytic Hypotension With the Addition of High Dialysate Calcium Concentration to Midodrine and/or Cool Dialysate
Alappan R, Cruz D, Abu-Alfa A, Mahnensmith R, Perazella M. Treatment of Severe Intradialytic Hypotension With the Addition of High Dialysate Calcium Concentration to Midodrine and/or Cool Dialysate. American Journal Of Kidney Diseases 2001, 37: 294-299. PMID: 11157369, DOI: 10.1053/ajkd.2001.21292.Peer-Reviewed Original ResearchConceptsHigh dialysate calcium concentrationSevere intradialytic hypotensionDialysate calcium concentrationIntradialytic hypotensionBlood pressureEnd-stage renal disease populationCalcium concentrationLow dialysate calciumSeverity of hypotensionMean arterial pressurePeripheral vascular resistanceIntradialytic blood pressureRenal disease populationProspective crossover studyTreatment of patientsMultiple pathogenic factorsType of therapyDialysate calciumHemodynamic instabilityVascular resistanceHemodynamic stabilityArterial pressureCrossover studyCardiac outputCool dialysate
1999
Midodrine and cool dialysate are effective therapies for symptomatic intradialytic hypotension
Cruz D, Mahnensmith R, Brickel H, Perazella M. Midodrine and cool dialysate are effective therapies for symptomatic intradialytic hypotension. American Journal Of Kidney Diseases 1999, 33: 920-926. PMID: 10213650, DOI: 10.1016/s0272-6386(99)70427-0.Peer-Reviewed Original ResearchConceptsSymptomatic intradialytic hypotensionPost-HD blood pressuresIntradialytic blood pressureIntradialytic hypotensionBlood pressureEffective therapyLaboratory valuesCombination therapy phaseConsecutive HD treatmentsProspective crossover studyBlood pressure measurementsKt/VVolume of salineControl phaseAlpha1 agonistHypotensive symptomsMorbid complicationCrossover studyUseful therapyProspective studyNursing interventionsHD treatmentMidodrineTreatment phaseTherapy phase
1998
Midodrine is effective and safe therapy for intradialytic hypotension over 8 months of follow-up.
Cruz D, Mahnensmith R, Brickel H, Perazella M. Midodrine is effective and safe therapy for intradialytic hypotension over 8 months of follow-up. Clinical Nephrology 1998, 50: 101-7. PMID: 9725781.Peer-Reviewed Original ResearchConceptsSymptomatic intradialytic hypotensionIntradialytic hypotensionMidodrine therapyHD sessionSafe therapyEnd-stage renal disease patientsStage renal disease patientsAlpha-1 adrenergic agonistMean ultrafiltration volumeSignificant causative roleRenal disease patientsTreatment-related factorsPatient-specific factorsMost therapeutic interventionsKt/VHypotensive symptomsBlood pressureHemodialysis patientsHD patientsDisease patientsSubjective improvementAdverse reactionsFrustrating complicationMean albuminSafe treatment
1997
Intradialytic hypotension: Is midodrine beneficial in symptomatic hemodialysis patients?
Cruz D, Mahnensmith R, Perazella M. Intradialytic hypotension: Is midodrine beneficial in symptomatic hemodialysis patients? American Journal Of Kidney Diseases 1997, 30: 772-779. PMID: 9398120, DOI: 10.1016/s0272-6386(97)90081-0.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAdrenergic alpha-AgonistsAgedAged, 80 and overBlood PressureDiastoleDizzinessFatigueFemaleFollow-Up StudiesHumansHypotensionKidney Failure, ChronicLongitudinal StudiesMaleMiddle AgedMidodrineMuscle CrampMuscle WeaknessParesthesiaProspective StudiesPulseRenal DialysisRisk FactorsSafetyScalpSystoleConceptsDiastolic blood pressureSystolic blood pressureBlood pressureMidodrine therapyArterial pressureHemodialysis patientsIntradialytic hypotensionPulse rateEnd-stage renal disease patientsIntradialytic systolic blood pressureEfficacy of midodrineSymptomatic hemodialysis patientsNeurogenic orthostatic hypotensionMean arterial pressureRenal disease patientsAdequate patient numbersBlood pressure measurementsAlpha-adrenergic agonist activityConsecutive dialysis sessionsAutonomic dysfunctionDialysis hypotensionOral agentsOrthostatic hypotensionSymptomatic hypotensionProspective trial