Cloridrato de sertralina não previne hipotensão intradialítica: estudo cruzado, duplo cego, randomizado, controlado com placebo

• Ano de defesa: 2005
• Autor(a) principal: Eye, Osvaldo Simões Pires von
• Orientador(a): Figueiredo, Carlos Eduardo Poli de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: NEFROLOGIA; PRESSÃO SANGUÍNEA; DIÁLISE RENAL; PLACEBO TERAPIA; ANTIDEPRESSIVOS
• Link de acesso: http://hdl.handle.net/10923/4445

Background: The efficacy of sertraline hydrochloride to prevent intradialytic hypotension has not been established. Methods: A cross over double-blind, randomized, placebo-controlled study was performed with 18 patients presenting more than 15 hypotension episodes in the last 25 hemodialysis sessions. One group received eight weeks of sertraline hydrochloride 50mg/daily followed by eight weeks of placebo. The second group received eight weeks of placebo followed by eight weeks of sertraline hydrochloride 50mg/daily. Data from the four final weeks of each eight-week period were considered. The following variables were assessed: weight, ultrafiltration, arterial blood pressure, hypotension episodes, nursing interventions, laboratory data and depressive symptoms (Beck Inventory). Data were analyzed using the usual statistical methods and a model which identifies interference by a period (practice) or period-treatment (carry-over) effect. Results: At baseline, the mean number of hypotensive episodes per session was 0. 8 ± 0. 1 [median 0. 7 (0. 6 - 0. 9)], vs. 0. 5 ± 0. 4 [0. 33 (0. 08 - 0. 83)] with sertraline use and 0. 3 ± 0. 2 [0. 21 (0. 17 - 0. 42)] with placebo. The number of hypotensive episodes before the study was significantly higher than during placebo (p = 0. 001) and sertraline treatment (p = 0. 027). The number of hypotension episodes and nursing interventions was similar during placebo and sertraline use. A period-treatment effect was observed for the variables Beck depression score and successful ultrafiltration. A period effect was observed for pre- and post-dialysis weight and successful ultrafiltration. A treatment effect was observed for interdialytic gain and ultrafiltration that were higher in the placebo group, and for number of hypotensive episodes per session, that was lower in this group. Conclusion: Sertraline was not useful to prevent intradialytic hypotension in the present study.