Frequency of Orthostatic Hypotension During Inpatient Rehabilitation in Patients with Impaired Renal Function Taking Silodosin:

The elderly and patients with impaired renal function are at a higher risk of orthostatic hypotension (OH). We retrospectively investigated OH incidence during rehabilitation in patients who were prescribed silodosin and underwent out-of-bed rehabilitation by a physiotherapist and were admitted to our hospital between January 2023 and July 2024. OH was found in 22 of 60 patients (36.7％) in the renal impairment group and 5 of 42 patients (11.9％) in the patients with preserved renal function, with a significantly higher incidence in the renal impairment group. Among the renal impairment group, the OH frequency was 35.7％ in patients receiving reduced doses of silodosin and 37.0％ in those on regular doses. Estimated creatinine clearance (eCCr) < 50 mL/min OR 3.2 (95％ CI: 1.04 – 9.74, P = 0.04) was identified as an independent factor for OH occurrence in patients taking silodosin. The OH frequency during hospitalization in patients with eCCr < 50 mL/min taking silodosin is as high as about 37％, and efforts should be made to prevent adverse events such as syncope and falls through multidisciplinary cooperation.