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Effect of mineralocorticoids on interdialytic weight gain in hemodialysis patients with perdialytic hypotension
Author(s) -
Mercadal Lucile,
Petitclerc Thierry
Publication year - 2005
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2005.01150.x
Subject(s) - medicine , fludrocortisone , midodrine , hemodialysis , orthostatic vital signs , thirst , blood pressure , aldosterone , cardiology , anesthesia , hydrocortisone
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.