Leg Ulceration during Amezinium Methyl Sulfate Therapy for Hypotension in a Hemodialyzed Patient with Generalized Vascular Calcification

Kitano, Yuichi; Nomura, Shinsuke; Saiki, Toyonori; Osawa, Gengo

doi:10.1159/000188692

Cited by 3 publications

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“…A cohort study showed that the use of midodrine is associated with risk of death 11 . There were also reports that midodrine hydrochloride and amezinium metilsulfate might have worsened the leg ulcers in HD patients 16,17 . IDH causes hypoperfusion in organs causing myocardial infarction, stroke, and bowel ischemia, and leads to myocardial fibrosis and cardiac remodeling 18 .…”

Section: Discussionmentioning

confidence: 99%

Use of vasopressor for dialysis-related hypotension is a risk factor for death in hemodialysis patients: Nationwide cohort study

Kanda

Tsuruta²,

Kikuchi³

et al. 2019

Sci Rep

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Because hypotension during hemodialysis (HD) makes continuation of HD difficult and is associated with mortality, pressor approaches are necessary for patients with hypotension. However, the relationships between the pressor approaches and the risk of death have not been clarified yet. We analyzed data from a nationwide prospective cohort study of the Japanese Society for Dialysis Therapy Renal Data Registry (n = 29,309). The outcome was all-cause one-year death. The association between the use of pressor approaches and the outcome was examined using Cox proportional hazards models adjusted for baseline characteristics, propensity score matched analysis and Bayesian networks. The background features of the patients were as follows: male, 59.6%; average age, 64.5 ± 12.5 years; and patients with diabetes mellitus, 31.5%. The pressor group showed a higher risk of the outcome than the control group [adjusted hazard ratio (aHR) 1.33 (95% CI: 1.21, 1.47), p = 0.0001]. Propensity score matched analysis also showed that the matched-pressor group had a higher risk of the outcome than the matched-control group [aHR 1.30 (95% CI: 1.17, 1.45), p = 0.0001]. Moreover, the Bayesian network showed a direct causal relationship from the use of pressor approaches to the outcome. The use of oral vasopressors [aHR 1.20 (95% CI: 1.07, 1.35), p = 0.0018], intravenous injection of vasopressors [aHR 1.54 (95% CI: 1.32, 1.79), p = 0.0001] and normal saline [aHR 1.18 (95% CI: 1.05, 1.33), p = 0.0066] were associated with a high risk of the outcome. In conclusion, this study showed that the use of pressor approaches during HD may be an independent risk factor for death.

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Section: Discussionmentioning

confidence: 99%

Use of vasopressor for dialysis-related hypotension is a risk factor for death in hemodialysis patients: Nationwide cohort study

Kanda

Tsuruta²,

Kikuchi³

et al. 2019

Sci Rep

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Skin Necrosis and Ulcers Induced by Medications

Dissemond

2014

Skin Necrosis

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Medications

Dissemond

2011

Hautarzt

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In the last few decades it has been reported that the intake of some drugs may lead to the onset of a leg ulcer. In the etiology particularly allergic and toxic mechanisms have been postulated to induce pathological reactions which potentially lead to vasculitis or vasculopathies. The causal association of the intake of drugs and the occurrence of a leg ulcer is not always clearly proven. Most of the presented drugs in this overview are substances for which only a few case reports has been described for an association with leg ulcers. Diagnoses are often made by exclusion of other causes and because of a temporal relationship. One exception is drugs which contain the active ingredient hydroxyurea. More than 100 published patients have developed leg ulcers while on hydroxyurea. Moreover, these ulcerations have a typical clinical morphology. Numerous systemic medicaments can lead directly or indirectly to the onset of a leg ulcer. Therefore it is important to recognize this potentially relevant factor and adjust the medications as part of the therapeutic plan.

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Leg Ulceration during Amezinium Methyl Sulfate Therapy for Hypotension in a Hemodialyzed Patient with Generalized Vascular Calcification

Cited by 3 publications

References 1 publication

Use of vasopressor for dialysis-related hypotension is a risk factor for death in hemodialysis patients: Nationwide cohort study

Use of vasopressor for dialysis-related hypotension is a risk factor for death in hemodialysis patients: Nationwide cohort study

Skin Necrosis and Ulcers Induced by Medications

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