title: Effect of intranasal DDAVP in prevention of hypotension during hemodialysis.
abstract: BACKGROUND
  The development of intradialytic hypotension during hemodialysis (HD) in which fluid removal is the primary goal, contributes to the excessive morbidity that is associated with the dialysis procedure.
  
  
  METHODS
  In a double blinded clinical trial, we compared the possible effect of intranasal DDAVP with intranasal distilled water as a placebo in prevention of intradialytic hypotension (IDH) in patients with known symptomatic IDH. In the first month of the study, nasal spray of distill water were administrated 30 minutes before all HD session (Placebo Group, Group 1) and then after a 30-day washout period we were used intranasal DDAVP 30 minutes before HD session (Vasopressin Group, Group 2). Blood pressure was measured just before HD, two hours later and after termination of HD. A hypotensive episode was defined as a decline of systolic blood pressure of more than 10mm Hg.
  
  
  RESULTS
  In overall Seventeen patients (nine men, eight women; mean age, 47.5 years) with known symptomatic IDH were enrolled in the study. The kind of dialysis membranes, mean of blood flow rate, dialyzate flow rate and ultrafiltration rate were the same in both groups. Each group has 204 HD session (17 * 12). Hypotensive episode occurred 18 times (8.82%) in vasopressin group compared with 125 times (61.27%) in placebo group and there was a significant association between them (p=0.0001). In addition mean arterial blood pressure in vasopressin group was 80.77 and in placebo group was 73.92 and also there was a significant association (p=0.0001). The mean Kt/v in group 1 and 2 were 1.29 and 1.28 without any differences between them (p=0.896).
  
  
  CONCLUSIONS
  These results indicate that Compared with placebo, Vasopressin is significantly associated with a decreased incidence of intradialytic hypotension episodes during hemodialysis.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran. Beladimusavi@yahoo.com
authors.forename: Seyed S
authors.initials: SS
authors.lastname: Beladi-Mousavi
authors.forename: Marzieh
authors.initials: M
authors.lastname: Beladi-Mousavi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Hayati
authors.forename: Mehdi
authors.initials: M
authors.lastname: Talebzadeh
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D003894:Deamino Arginine Vasopressin