1231 GMT January 19, 2019
“Clonidine is widely used in dialysis patients, with about 20 percent on the medication long-term,” Gwendolyn Derk, MD, from the University of Illinois, told Healio Nephrology, healio.com reported.
Derk and colleagues performed a systematic review and meta-analysis of eight studies to investigate the safety and efficacy of clonidine for hypertension treatment in adult patients on hemodialysis. The duration of the studies ranged from two to eight weeks.
The assessed studies were highly biased, Derk said.
The researchers identified several significant adverse events associated with oral and patch clonidine, including hypotension, lightheadedness, drowsiness, dry mouth, rebound hypertension and contact dermatitis. Short-term use of clonidine was associated with significant improvement in systolic BP, but not diastolic BP.
“There is no evidence supporting the long-term use of clonidine in hemodialysis patients,” Derk said.
“We don’t have the evidence to be doing this and yet we are.”
“I believe there to be a potential for there to be a long-term effect of clonidine use that would not be positive, such as more fluid retention, more fluid overload and volume overload over time and likely worse cardiovascular outcomes,” she said.
Derk mentioned that she and her team are working on a protocol to deprescribe certain BP medications in dialysis patients.
“We are doing more harm than good by having these patients on this medication long-term and we should focus more on the volume control side to manage their BP rather than prescribing a medication,” she said.