Dialysis Patients Can Avoid Serious Complications by Using Medication That Normally Treats Low Blood Pressure, Yale Researcher Reports

Apr 20, 2001, 01:00 ET from Yale School of Medicine

    NEW HAVEN, Conn., April 20 /PRNewswire Interactive News Release/ --
 Studies presented today by a Yale researcher at the annual National Kidney
 Foundation Meeting in Orlando, Florida, show that midodrine hydrochloride, a
 medication normally used to treat low blood pressure, may also help kidney
 disease patients avoid some of the serious side effects of dialysis.
     "The results of the studies show that midodrine not only effectively
 blunts the fall in blood pressure during and after dialysis, but it is also
 well-tolerated and easy to administer," said Mark Perazella, M.D., associate
 professor of medicine and director of the Acute Dialysis Services at Yale
 School of Medicine.
     About 250,000 patients with end-stage renal disease undergo dialysis, a
 life-saving procedure that clears toxins and excess fluids from the blood.
 Between dialysis sessions, the patients accumulate excess fluids, but after
 the fluids are removed, the vessels are unable to constrict and return blood
 to the heart, causing intradialytic hypotension (IDH), or very low blood
 pressure.
     This condition affects 20 to 50 percent of dialysis patients and can cause
 nausea, vomiting, dizziness and even life-threatening symptoms such as
 abnormal heart rhythms and diminished blood supply to the heart and brain.
 These side effects often cause patients to stop treatments. Perazella said
 that most medications used to treat IDH in the past have been either modestly
 effective or poorly tolerated.
     IDH occurs most often in dialysis patients who are older, people with
 diabetes or heart disease, and people whose bodies cannot automatically
 compensate for dialysis-induced fluid loss by constricting the blood vessels
 to maintain blood return to the heart. The number of at-risk patients is
 growing; at least 20 percent of dialysis patients are over 65, and more than
 half suffer from other illnesses, such as diabetes or high blood pressure.
     "The complications of IDH take a substantial toll on patients' health and
 quality of life, which can force them to discontinue dialysis in the middle of
 their treatment," Perazella said. "This can increase the risk of infections
 and prolonged bleeding, and can even cause premature death. These data found
 that midodrine can reduce the symptoms associated with abnormally low blood
 pressure that can occur during dialysis."
     Midodrine works by stimulating nerve endings in the blood vessels, causing
 them to constrict. As a result, blood pressure is increased. It is used more
 broadly to treat orthostatic hypotension, a condition in which people
 experience low blood pressure and other cardiovascular symptoms after standing
 up from a sitting position, or after standing in a fixed position for a
 prolonged period of time.
     In studies published in the American Journal of Kidney Diseases, Perazella
 found that midodrine was effective in patients with IDH who were resistant to
 other therapies. He also showed that the effects of midodrine were long-
 lasting. A significant improvement in patients was noted at one, five, and
 eight months of therapy. In a comparative study with cool dialysate, a proven
 therapy for dialysis-associated hypotension, Perazella found that midodrine
 was associated with fewer side effects, and there were no adverse effects
 observed in any of the studies. Midodrine was also shown to be effective in
 elderly patients as well as those with diabetes.
 
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SOURCE Yale School of Medicine
    NEW HAVEN, Conn., April 20 /PRNewswire Interactive News Release/ --
 Studies presented today by a Yale researcher at the annual National Kidney
 Foundation Meeting in Orlando, Florida, show that midodrine hydrochloride, a
 medication normally used to treat low blood pressure, may also help kidney
 disease patients avoid some of the serious side effects of dialysis.
     "The results of the studies show that midodrine not only effectively
 blunts the fall in blood pressure during and after dialysis, but it is also
 well-tolerated and easy to administer," said Mark Perazella, M.D., associate
 professor of medicine and director of the Acute Dialysis Services at Yale
 School of Medicine.
     About 250,000 patients with end-stage renal disease undergo dialysis, a
 life-saving procedure that clears toxins and excess fluids from the blood.
 Between dialysis sessions, the patients accumulate excess fluids, but after
 the fluids are removed, the vessels are unable to constrict and return blood
 to the heart, causing intradialytic hypotension (IDH), or very low blood
 pressure.
     This condition affects 20 to 50 percent of dialysis patients and can cause
 nausea, vomiting, dizziness and even life-threatening symptoms such as
 abnormal heart rhythms and diminished blood supply to the heart and brain.
 These side effects often cause patients to stop treatments. Perazella said
 that most medications used to treat IDH in the past have been either modestly
 effective or poorly tolerated.
     IDH occurs most often in dialysis patients who are older, people with
 diabetes or heart disease, and people whose bodies cannot automatically
 compensate for dialysis-induced fluid loss by constricting the blood vessels
 to maintain blood return to the heart. The number of at-risk patients is
 growing; at least 20 percent of dialysis patients are over 65, and more than
 half suffer from other illnesses, such as diabetes or high blood pressure.
     "The complications of IDH take a substantial toll on patients' health and
 quality of life, which can force them to discontinue dialysis in the middle of
 their treatment," Perazella said. "This can increase the risk of infections
 and prolonged bleeding, and can even cause premature death. These data found
 that midodrine can reduce the symptoms associated with abnormally low blood
 pressure that can occur during dialysis."
     Midodrine works by stimulating nerve endings in the blood vessels, causing
 them to constrict. As a result, blood pressure is increased. It is used more
 broadly to treat orthostatic hypotension, a condition in which people
 experience low blood pressure and other cardiovascular symptoms after standing
 up from a sitting position, or after standing in a fixed position for a
 prolonged period of time.
     In studies published in the American Journal of Kidney Diseases, Perazella
 found that midodrine was effective in patients with IDH who were resistant to
 other therapies. He also showed that the effects of midodrine were long-
 lasting. A significant improvement in patients was noted at one, five, and
 eight months of therapy. In a comparative study with cool dialysate, a proven
 therapy for dialysis-associated hypotension, Perazella found that midodrine
 was associated with fewer side effects, and there were no adverse effects
 observed in any of the studies. Midodrine was also shown to be effective in
 elderly patients as well as those with diabetes.
 
                     MAKE YOUR OPINION COUNT -  Click Here
                http://tbutton.prnewswire.com/prn/11690X57543252
 
 SOURCE  Yale School of Medicine