Use of midodrine (Gutron) to treat permanent hypotension in a chronic hemodialysis patient

Chronic hypotension, infrequent though possible in chronic renal failure pa tients on hemodialysis, has harmful consequences on their physical state an d hence general well-being. These patients often experience acute intradial ytic manifestations while non-pharmacologic interventions as pharmacologic agents are sometimes insufficient to improve symptoms. Well tolerated, mido drine appears to be a suitable and effective agent as it raises blood press ure significantly via its effect on peripheral a-adrenergic receptors. The authors describe their use of midodrine in a dialysis patient for the longe st period of time reported up to now, documented by a pharmacokinetic study , confirming long-term both clinical efficacy and safety of the drug.