Comparison of the effects of sertraline and L-carnitine on intradialytic hypotension; a double blind clinical trial

Abstract

Introduction: Although some studies have reported the positive effect of sertraline and L-carnitine on intradialytic hypotension (IDH), a common complication of dialysis, however the results are controversial. Objectives: The aim of this study was to compare the effects of sertraline and L-carnitine on blood pressure in patients with chronic renal failure who were undergoing dialysis. Patients and Methods: This double-blind clinical trial was conducted on 32 hemodialysis patients who suffered from IDH in more than 50% of dialysis sessions. Patients were randomly divided into two groups of sertraline (50 mg daily) and L-carnitine (1000 mg daily), with 16 patients in each group. Duration of treatment was four weeks, then patients were followed up for additional three weeks. The changes in patients’ blood pressure were monitored in each group and the results compared between the two groups. Results: Of all, 18 patients (56%) were female, 14 patients (44%) were male, and their mean (SD) age was 60±15 years. At the end of the study, mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), and mean arterial pressure (MAP) were significantly increased in both the sertraline and L-carnitine groups (P<0.05). In addition, nadir SBP, nadir DBP, and nadir MAP in each group were significantly increased compared to pre-treatment period (P<0.001). An increase of more than 5 mm Hg in SBP, DPB, and MAP was observed in half of the subjects in the sertraline group and more than two-thirds of the patients in the L-carnitine group, however there was no significant difference between the two groups (P>0.05). Conclusion: The findings of this study showed that the administration of sertraline or L-carnitine for one month could significantly increase SBP, DBP, MAP, and nadir blood pressures in dialysis patients suffering from IDH during dialysis sessions because there was no significant difference between the two drugs.