Korean Journal of Nephrology 2000;19(1):101-105.

원저 : 혈액 투석시 발생하는 저혈압에 대한 Amezinium Methylsulfate(Risumic)의 예방 효과에 대한 다기관 공동연구 (Preventive Effect of Amezinium Methylsulfate(Risumic) on Hemodialysis-Induced Hypotension A Multi-Center Trial)

김용수(Yong Soo Kim),방병기(Byung Kee Bang),김영옥(Young Ok Kim),송호철(Ho Chul Song),양철우(Chul Woo Yang),박정희(Jung Hee Park),박주현(Joo Hyun Park),김병수(Byung Soo Kim),박철휘(Cheol Whee Park),안석주(Suk Ju Ahn),최의진(Eui Jin Choi),신영신(Young Shin

Abstract

Background
: Dialysis-induced hypotension is a very common but difficult complication to manage. Amezi-nium methylsulfate is a newly developed sympatho-mimetic agent which has been reported as effective in postural hypotension. We studied the preventive effect of amezinium methylsulfate on dialysis-induced hypo- tension in chronic hemodialysis patients. Methods: Twenty-five hemodialysis(HD) patients who were maintaining on hemodialysis longer than 3 months and had frequent episodes of dialysis hypoten-sion were enrolled in this study. After 4 weeks of observation period, patients received one tablet of ameziniurn 30 minutes prior to every hemodialysis session for 4 weeks. We com mean arterial pressure(MAP), number of hypotensive episodes and number of nursing interventions(defined as position change, bolus injection of saline or 50% dextrose in water, need to decrease transmembrane pressure or discon- tinuation of dialysis) between observation and medi-cation period in each patient. Results: The number of nursing interventions (mean, 2.5±0.9 interventions vs. 1.4±0.9 interventions, p<0.05) and hypotensive episodes(mean, 1.7±0.7 episodes per session vs. 0.9±0.7 episodes per session; p<0.05) decreased significantly in the medication period and the nadir MAP(57±13mmHg vs 70±15mmHg; p<0.05), mid-HD MAP(65±15mmHg vs. 79±15mmHg; p<0.05) and post-HD MAP(66±14mmHg vs 78±16 mmHg ; p<0.05) are higher in the medication period compared with observation period. Conclusion : These results show that amezinium methylsulfate is useful to prevent dialysis-induced hypotension in chronic hemodialysis patients.