title: Effect of mineralocorticoids on interdialytic weight gain in hemodialysis patients with perdialytic hypotension.
abstract: 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.
authors.affiliation: Hôpital Pitié-Salpétrière, 83 BD de L'Hôpital, Paris, France. lucile.mercadal@psl.ap-hop-paris.fr
authors.forename: Lucile
authors.initials: L
authors.lastname: Mercadal
authors.forename: Thierry
authors.initials: T
authors.lastname: Petitclerc
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage; D000368:Aged; D000893:Anti-Inflammatory Agents; D001794:Blood Pressure; D004351:Drug Resistance / Q000187:drug effects; D005260:Female; D005438:Fludrocortisone; D006801:Humans; D007008:Hypokalemia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008879:Midodrine / Q000008:administration & dosage; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D012084:Renin-Angiotensin System / Q000187:drug effects
chemical_list: D000316:Adrenergic alpha-Agonists; D000893:Anti-Inflammatory Agents; D008879:Midodrine; D005438:Fludrocortisone