Infusing vasopressin to prevent intradialytic hypotension
Antonio Santoro
Correspondence Division of Nephrology, Dialysis and Hypertension, Policlinico S Orsola-Malpighi, Via P Palagi 9, 40138 Bologna, Italy
Email santoro@aosp.bo.it
This article has no abstract so we have provided the first paragraph of the full text.
The concept of controlling blood pressure in patients on dialysis by means of ultrafiltration was introduced in 1967 by Thomson.1 He defined 'dry weight' as the lowest possible extracellular fluid volume that could be achieved at the end of dialysis, accompanied by a reduction in blood pressure to normotension. Attempts to correct expansion of extracellular fluid volume with aggressive ultrafiltration often result, however, in hypovolemia and intradialytic hypotension. Various strategies—such as dialysate cooling, ultrafiltration modeling, sodium profiling2 and, more recently, automatic blood volume control3—have been deployed to facilitate ultrafiltration and to reduce the occurrence of symptomatic intradialytic hypotension. Even drugs such as midodrine,4 an alpha-adrenergic agonist, have been used with varying degrees of efficacy.
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