Captopril in temporary, non-dialytic management of pulmonary edema in end-stage renal disease

The only effective management of life-threatening hypervolemia in course of terminal renal failure is dialysis or hemofiltration. Nonetheless we succeeded in attenuating hypervolemic pulmonary edema utilizing low doses of Captopril in three patients awaiting entry into the maintenance hemodialysis program. The drug added to diuretic and, in two cases, digitalis therapy enabled pharmacologic management of patients volume overload for 12-25 days before the dialysis treatment could be started. No further decline in renal function or other side effects of Captopril were encountered. We conclude that Captopril may be life-saving in settings requiring pharmacologic relief of uremic pulmonary edema.