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Published on: February 2, 2021

Fenoldopam for acute kidney injury in children

Chad A Knoderer1, Jeffrey D Leiser, Corina Nailescu

  • 1Department of Pharmacy, Clarian Health Partners-Riley Hospital for Children, 702 Barnhill Drive, Room 1016, Indianapolis, IN 46202, USA. cknoderer@clarian.org

Pediatric Nephrology (Berlin, Germany)
|November 15, 2007
PubMed

Insights

Fenoldopam may help children with acute kidney injury (AKI) and mechanical circulatory support. One case showed improved kidney function, avoiding dialysis in pediatric cardiomyopathy patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Critical Care Medicine

Background:

  • Severe cardiomyopathy in children often necessitates mechanical circulatory support, such as ventricular assist devices (VADs).
  • Acute kidney injury (AKI) is a significant complication in pediatric patients with VADs, associated with high morbidity and mortality.
  • Limited therapeutic options exist for AKI in this vulnerable population.

Observation:

  • Two pediatric patients with severe cardiomyopathy requiring VADs developed AKI.
  • Fenoldopam, a dopamine-1 receptor agonist, was administered to both patients for management of AKI.
  • This represents the initial reported use of fenoldopam in pediatric patients with AKI on mechanical circulatory support.

Findings:

  • In one of the two cases, fenoldopam therapy was associated with a successful outcome.
  • The successful case demonstrated improved urine output and renal function, obviating the need for renal replacement therapy (RRT).
  • The second patient's outcome regarding fenoldopam efficacy was less clear, highlighting variability in response.

Implications:

  • Fenoldopam may be a potential therapeutic option for AKI in pediatric patients with VADs.
  • Further investigation is warranted to establish the safety and efficacy of fenoldopam in this specific patient group.
  • These findings may inform future clinical practice guidelines for managing AKI in critically ill children with cardiac support.

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