Captopril induced reversible acute renal failure in a premature neonate with double outlet right ventricle and congestive heart failure

Lin Hua Tan, Li Zhong Du, Michael R. Carr, Julia K. Kuzin, Brady S. Moffett, Anthony C. Chang

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Captopril is well tolerated in most patients. There is no report of acute deterioration in renal function after administration of captopril in neonates with congestive heart failure secondary to congenital heart defects with large left-to-right shunts. Methods: We report a premature neonate with double outlet right ventricle and congestive heart failure who developed acute renal failure after administration of captopril at a low dose of 0.1 mg/kg per 8 hours. Results: On the third day after captopril therapy, the levels of serum creatinine and blood urea nitrogen increased to 2.6 mg/dl and 73 mg/dl respectively, and hyperkalemia appeared. Captopril was discontinued immediately. On the fourth day, the infant developed oliguria which persisted for 24 hours and resolved on the fifth day when the serum potassium normalized to 4.5 mmol/L. The level of serum creatinine peaked at 3.9 mg/dL on the sixth day and gradually decreased to normal on the ninth day after administration of captopril. The captopril-induced acute renal failure resolved completely after cessation of the drug. Conclusions: Attention should be given to captopril therapy in premature neonates with congestive heart failure secondary to congenital heart disease with large left-to-right shunts. Routine hemodynamic examination and biochemical monitoring are suggested before and during captopril therapy.

Original languageEnglish (US)
Pages (from-to)89-91
Number of pages3
JournalWorld Journal of Pediatrics
Volume7
Issue number1
DOIs
StatePublished - Feb 2011

Keywords

  • acute renal failure captopril
  • congestive heart failure
  • neonate

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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