Ibarra-Sifuentes Héctor Raúl, Del Cueto-Aguilera Ángel, Gallegos-Arguijo Daniel Alberto, Castillo-Torres Sergio Andres, Vera-Pineda Raymundo, Martínez-Granados Rolando Jacob, Atilano-Díaz Alexandro, Cuellar-Monterrubio Jesus Eduardo, Pezina-Cantú Cesar Octaviano, Martínez-Guevara Edgar de Jesús, Ortiz-Treviño Juan Francisco, Delgado-García Guillermo Rubén, Martínez-Jiménez José Guadalupe, Cruz-Valdez Jesús, Sánchez-Martínez Concepción
Department of Internal Medicine, Autonomous University of Nuevo León, University Hospital, Mexico.
Nephrology, Department of Internal Medicine, Autonomous University of Nuevo León, University Hospital, Mexico.
Ther Apher Dial. 2017 Oct;21(5):459-464. doi: 10.1111/1744-9987.12553. Epub 2017 Aug 14.
Intradialytic hypotension is common complication in stage 5 chronic kidney disease patients on hemodialysis. Incidence ranges from 15 to 30%. These patients have levocarnitine deficiency. A randomized, placebo-controlled quadruple-blinded trial was designed to demonstrate the levocarnitine efficiency on intradialytic hypotension prevention. Patients were randomized into four groups, to receive levocarnitine or placebo. During the intervention period, levocarnitine and placebo was administered 0 and 30 min before each hemodialysis session, respectively. During the trial, 33 patients received 1188 hemodialysis sessions. We identified 239 (21.3%) intradialytic hypotension episodes. The intradialytic hypotension episodes were less frequent in the levocarnitine group (9.3%, 60 IH events) (P < 0.001). Hemodialysis is frequently perplexed by intradialytic hypotension episodes. Levocarnitine supplementation before each hemodialysis session efficiently diminishes the intradialytic hypotension episodes. This is a new application method that must be considered and explored.
透析中低血压是接受血液透析的5期慢性肾脏病患者常见的并发症。发生率在15%至30%之间。这些患者存在左旋肉碱缺乏。一项随机、安慰剂对照的四盲试验旨在证明左旋肉碱在预防透析中低血压方面的效果。患者被随机分为四组，分别接受左旋肉碱或安慰剂。在干预期内，左旋肉碱和安慰剂分别在每次血液透析治疗前0分钟和30分钟给药。在试验期间，33例患者接受了1188次血液透析治疗。我们共识别出239次（21.3%）透析中低血压事件。左旋肉碱组的透析中低血压事件发生率较低（9.3%，60次低血压事件）（P<0.001）。血液透析经常受到透析中低血压事件的困扰。每次血液透析治疗前补充左旋肉碱可有效减少透析中低血压事件。这是一种必须考虑和探索的新应用方法。
