Background and Aim: Release of damage associated molecular patterns pathogen in cirrhotics lead to splanchnic vasodilatation renin angiotensin aldosterone system (RAAS) activation ultimately resulting development various complications related cirrhosis. Midodrine, an alpha-1 adrenergic agonist, causes vasoconstriction counteracting arterial hypovolemia inhibiting RAAS activation. We conducted t...

A fter 7 days of oral midodrine therapy for symptomatic idiopathic hypotension, a 74-year-old woman presented with angina at a local hospital. Her vital signs were normal, and physical examination revealed nothing unusual. Results of chest radiography, a complete blood count, and a chemistry profile, including cardiac troponin T and creatine kinase, were normal. An electrocardiogram revealed ST...

A critical appraisal and clinical application of Skagen C, Einstein M, Lucey MR, Said A. Combination treatment with octreotide, midodrine, and albumin improves survival in patients with type 1 and type 2 hepatorenal syndrome. J Clin Gastroenterol. 2009 Aug;43(7):680-5. doi: 10.1097/MCG.0b013e318188947c

BACKGROUND The efficacy of vasoconstrictors in hepatorenal syndrome (HRS) is variable. We hypothesized that the effectiveness of vasoconstrictor therapy in improving kidney function ultimately relates to the magnitude of the achieved mean arterial pressure (MAP) increase. METHODS A retrospective study was conducted to identify cirrhotic individuals treated with vasoconstrictors for acute kidn...

Association of APOL1 variants with mild kidney disease in the first-degree relatives of African American patients with non-diabetic end-stage renal disease. et al. Genome-wide association scan for diabetic nephropathy susceptibility genes in type 1 diabetes. Sir, We have read with great interest the manuscript from Davenport et al. [1], concerning the medical management of patients with hepator...

Severely affected patients with autonomic failure require pressor agents to counteract the blood pressure fall and improve presyncopal symptoms upon standing. Previous studies suggest that combination ergotamine and caffeine may be effective in the treatment of autonomic failure, but the efficacy of this drug has not been evaluated in controlled trials. Therefore, we compared the effects of erg...

Individuals with spinal cord injury (SCI) above the T6 spinal segment suffer from orthostatic intolerance. How cerebral blood flow (CBF) responds to orthostatic challenges in SCI is poorly understood. Furthermore, it is unclear how interventions meant to improve orthostatic tolerance in SCI influence CBF. This study aimed to examine 1) the acute regional CBF responses to rapid changes in blood ...

A critical appraisal and clinical application of Esrailian E, Pantangco ER, Kyulo NL, Hu KQ, Runyon BA. Octreotide/midodrine therapy significantly improves renal function and 30-day survival in patients with type 1 hepatorenal syndrome. Dig Dis Sci. 2007;52(3):742-748. doi: 10.1007/s10620-006-9312-0