Treatment of acute renal failure (ARF) and oliguria/anuria in three prematurely delivered infants with fenoldopam – three cases report

摘要

Background: Fenoldopam – a dopamine analogue - stimulates postsynaptic D1 receptors in the renal and splanchnic circulatory vessels and has no activity on D2 receptors, α and β adrenergic receptors. It increases RBF and urine output, without significant changes in the blood pressure.Due to those effects, we decided to use fenoldopam in the treatment of infants undergoing acute renal failure in oliguric state.Case Report: We present the schedule of the therapy of three premature newborns, whom we administered fenoldopam (dose 0.1 µg × kg–1 × min–1) in ARF. We observed the improvement in kidney function and urinary output. The first patient suffered from ARF secondary to SIRS and the abdominal aortic embolism. A recovery of renal function and improvement of clinical state have been observed after introduction of a complex therapy including fenoldopam).Next patient developed ARF on the third day after delivery. The inborn infection, hepatic failure, and dyspnoea have accompanied ARF. Although he was given a complete treatment and fenoldopam infusion leading to increase in diuresis, he died in the course of DIC.In the third infant sepsis was the cause of arising ARF on 19th day of life. Two days of using fenoldopam resulted in enlarging urinary output and return of renal function.Conclusions: The normalisation of renal parameters depended on the combination of traditional methods of therapy with the administration of fenoldopam. The positive effects of the therapy indicate the safety of usage and proposed dosage of fenoldopam in infants and should be verified in further studies.