Christine Zomer Dal Molin
University of Southern Santa Catarina, Brazil
: J Kidney
Introduction: Intradialytic hypotension (IDH) is a major complication of hemodialysis, with a prevalence of about 25% of episodes during hemodialysis sessions, causing increased morbimortality. Previous studies have indicated that selective serotonin reuptake inhibitors (SSRIs) may improve IDH episodes. This was a double-blind, crossover clinical trial comparing the use of sertraline versus placebo to reduce intradialytic hypotension. Methods: IDH was characterized by the following: a decrease of at least 30mmHg in the systolic blood pressure (SBP) or prehemodialysis SBP less than or equal to 100 mmHg with associated symptoms; any measure of SBP lower than 90mmHg and/or a diastolic blood pressure (DBP) less than 40mmHg; symptoms requiring intervention by the nursing team. Results: Sixteen patients completed the 12-week period. The IDH prevalence was 32%. A comparison between intradialytic interventions, intradialytic symptoms, and IDH episodes revealed no statistical difference in the reduction of IDH episodes (p=0.207) between the two intervention groups. However, the risk of IDH Interventions was 60% higher in the placebo group compared to the sertraline group, and the risk of ID symptoms was 40% higher in the placebo group. Survival analysis by using the Kaplan???Meier estimator supported the results of this study. Sertraline presented a number needed to treat (NNT) of 16.3 patients to prevent an episode from IDH intervention and 14.2 patients to prevent an episode from intradialytic symptoms. Conclusion: This study suggests that the use of sertraline may be beneficial to reduce the number of symptoms and ID interventions, although there was no statistically significant difference in the blood pressure levels.
Christine Zomer Dal Molin has completed her Master’s degree in Health Sciences at the age of 31 years from University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil. She is a Nephrologist at Clínica de Nefrologia Ltda Araranguá, Santa Catarina; Nephrologist at Hospital Regional Affonso Guizzo Araranguá; Nephrologist at Clínica Marconato, Tubarão; Hospitalist at Hospital Socimed, Tubarão. Recently, was approved to become an associate professor at Universidade Federal de Santa Catarina, campus Araranguá, she will be teaching for Medical Students. She is applying for PhD in Health Sciences.
E-mail: christinezdm@hotmail.com
