title: Effect of sertraline hydrochloride on cardiac autonomic dysfunction in patients with hemodialysis-induced hypotension.
abstract: OBJECTIVE
  It was previously shown that sertraline hydrochloride treatment improved hemodynamic parameters of patients with dialysis induced hypotension (DIH). The aim of this study was to examine the effect of sertraline on the autonomic functions of patients with DIH.
  
  
  METHODS
  Ten patients with DIH, 10 hemodialysis patients without DIH and 10 healthy control subjects were included into the study. All of the patients were treated with sertraline 50 mg per day for 4 weeks. Pre-treatment and post-treatment heart rate variability (HRV) in supine and tilt position was evaluated. In order to evaluate the autonomic response to tilt position, gap values were calculated by subtracting the HRV in supine position from the HRV in tilt position.
  
  
  RESULTS
  Analysis of the HRV response to tilt, demonstrated a paradoxical reduction in the indices of sympathetic modulation and sympathovagal balance in the patients with DIH while there was an increase in normalized powers of low frequency components (LFNU) and low frequency to high frequency components ratio (LFP/HFP) in the patients without DIH and control group. The number of therapeutic interventions for restoration of DIH decreased significantly in the sertraline period (p < 0.001). The gap values of the patients with DIH in LFNU (sympathetic modulation) (p < 0.05) and LFP/HFP (sympathovagal balance) increased in the sertraline period (p < 0.01). The decrease in gap value of normalized powers of high frequency components (parasympathetic modulation) was pronounced in the sertraline period in the patients with DIH (p < 0.05).
  
  
  CONCLUSIONS
  The preventive effect of sertraline on DIH might be related to the improvement of regulation of autonomic response to hypovolemia.
authors.affiliation: Department of Nephrology, Osmangazi University Medical School, Eskisehir, Turkey. auyalcin@ogu.edu.tr
authors.forename: Ahmet Ugur
authors.initials: AU
authors.lastname: Yalcin
authors.forename: Gulmira
authors.initials: G
authors.lastname: Kudaiberdieva
authors.forename: Garip
authors.initials: G
authors.lastname: Sahin
authors.forename: Bulent
authors.initials: B
authors.lastname: Gorenek
authors.forename: Nevbahar
authors.initials: N
authors.lastname: Akcar
authors.forename: Serhat
authors.initials: S
authors.lastname: Kuskus
authors.forename: Figen
authors.initials: F
authors.lastname: Bayrak
authors.forename: Bilgin
authors.initials: B
authors.lastname: Timuralp
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy* / Q000503:physiopathology; D016022:Case-Control Studies; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000294:innervation* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D020280:Sertraline / Q000627:therapeutic use*; D016683:Supine Position; D018667:Tilt-Table Test
chemical_list: D020280:Sertraline