Low-dose dopamine in treating acute renal failure caused by preeclampsia

Acute renal failure is a serious complication of preeclampsia that usually requires the termination of pregnancy. We present a case of acute renal failure due to severe preeclampsia successfully treated with the infusion of a low dose of dopamine. This 25-year-old Japanese primigravida was admitted at 31 weeks of gestation for the treatment of preeclampsia. Urine output was decreased to 380 ml/day; 24-hour creatinine clearance was decreased to 13.7 liters/day. Blood urea nitrogen was elevated to 31.9 mg/dl; serum creatinine was elevated to 3.34 mg/dl. The diagnosis was acute renal failure related to preeclampsia. A low dose of dopamine, 1 microgram/kg/min, was infused daily for 7 days at 32 weeks of gestation to maintain urine output. Renal function improved markedly without any adverse effect on the patient's blood pressure which was controlled on hydralazine. Fetal distress developed 4 days later and emergency cesarean section was performed. A healthy female was delivered. The infusion of a low dose of dopamine appeared to be highly effective in managing acute renal failure caused by preeclampsia with no serious side effects.