title: Vasopressin and prevention of hypotension during hemodialysis.
abstract: BACKGROUND
  The occurrence of intradialytic hypotension (IDH) during hemodialysis (HD) continues to be a main problem in patients with ESRD (end-stage kidney disease). It also negatively affects health-related quality of life. We aimed to determine vasopressin effect in decreasing IDH.
  
  
  METHODS
  We reviewed clinical and experimental literature in a variety of sources, including PubMed, Current Content, Scopus, Embase, and Iranmedex regarding the possible effect of vasopressin administration in prevention of hypotension during HD to clarify its mechanism, efficacy, and safety.
  
  
  RESULTS
  Although arginine vasopressin is widely recognized for its anti-diuretic properties, it is also a well-recognized vasoconstrictor. It has been shown that the vasopressin release (as it would normally be expected) does not increase in the majority of HD patients with recurrent dialysis hypotension. In addition, it has also been reported that vasopressin secretion (due to the osmotic stimulation) is the most important mechanism in blood pressure control in ESRD patients receiving hypertonic solution for IDH. Therefore, it is suggested that vasopressin administration may improve hemodynamic stability among ESRD patients during HD. There are few clinical trials about this issue, suggesting that administration of exogenous vasopressin may be significantly associated with a decreased incidence of IDH as well as cardiovascular stability in ESRD patients in need of volume removal during HD.
  
  
  CONCLUSIONS
  Vasopressin insufficiency may have an important role in the pathogenesis of hemodynamic instability during HD and administration of exogenous vasopressin is significantly associated with a lower incidence of IDH.
authors.affiliation: Chronic Renal Failure Research Center, Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
authors.forename: Seyed Seifollah
authors.initials: SS
authors.lastname: Beladi Mousavi
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Mohamad Reza
authors.initials: MR
authors.lastname: Tamadon
keywords: Arginine Vasopressin; Hemodialysis; Hypotension