Sertraline hydrochloride (Selective serotonin reuptake inhibitor) Supplementation versus sodium dialysate modeling effect on intradialytic hypotension in end stage renal disease patients

Abstract

ESRD patients on regular hemodialysis are prone to have Intradialytic hypotension. Intradialytic hypotension is associated with undesirable symptoms such as abdominal discomfort, yawning, sighing, nausea, vomiting, muscle cramps, restlessness, dizziness, fainting, anxiety, and others. Intradialytic hypotension occurs more frequently in non-compliant patients, especially with too high inter-dialytic fluid intake, as well as in persons eating just before or during dialysis sessions. Efficient treatment of Intradialytic hypotension is still a great challenge. Adequate therapy is difficult and requires a multilevel strategy. Although there are many studies that have been studying the effect of different sodium profiling technique on IDH and some studies evaluating the effect of sertraline hydrochloride supplementation on IDH , there is no previous study that compared both sodium profiling and sertraline hydrochloride supplementation on controlling intradialytic hypotension. This study was cross over, included 20 ESRD patients with history of having intradialytic hypotensive episodes undergoing regular hemodialysis three times per week four hours each session in Al-Agoza hospital. The patients were divided in two groups group (A) and group (B). Group (A) started with sodium profiling technique with dialysate sodium starting with 152 mEq/dl and ending with 138 mEq/dl for three sessions. Then patients shifted to sertraline hydrochloride supplementation 50 mg/day for four weeks. With wash out period for two weeks.