Better peridialytic blood pressure control using carvedilol in end stage renal disease patients on twice weekly maintenance hemodialysis

Background While use of carvedilol in patients on hemodialysis is encouraged with its low dialyzability, evidence supporting its superiority over metoprolol in improving the blood pressure control during dialysis is lacking. This study was undertaken to study the blood pressure variations in the peridialytic period after conversion from metoprolol to carvedilol. Materials and methods In this this prospective, pre–post intervention study, patients on metoprolol were converted to carvedilol. Patients aged 18–65 years on biweekly dialysis with intradialytic rise in blood pressure {difference between pre- and post-dialysis systolic blood pressure > 10 mmHg with post-dialysis blood pressure of ≥ 130/80 mmHg} were recruited. The recorded blood pressure data post conversion to carvedilol was compared to the retrospective mean blood pressure recordings during metoprolol use. Results Of the 48 subjects, the study mostly comprised young males ( n -34, mean age- 37.06 ± 14.32 years). Both systolic and diastolic blood pressures at different time periods (pre-dialysis, intradialytic and post-dialysis) were significantly lower with carvedilol use than with metoprolol, p