Abstract

INSIGNARES-VIZCAINO, ZOILA MARGARITA; ECHEVERRI-CARDONA, MARGARITA MARÍA  and  FERNANDEZ-LAVERDE, MAURICIO. Acute renal failure induced for enalapril. CES Med. [online]. 2013, vol.27, n.1, pp.83-91. ISSN 0120-8705.

A number of drugs can cause nephrotoxicity in children. Some predisposing factors such as age, pharmacodynamics, pharmacokinetics, drug doses and concomitant medications influence the severity of nephrotoxicity. In children, especially in the neonatal period the incidence, prevalence and etiology of acute renal failure is poorly defined. However it is known that infants have a high incidence, especially after cardiac surgery, severe asphyxia or premature birth. Drug nephrotoxicity is a major cause of neonatal acute renal failure; the drugs were more related nonsteroidal anti-inflammatory drugs, aminoglycosides, vancomycin, amphotericin B, antiviral agents, and inhibitors of angiotensin converting enzyme and radiocontrast agents. The pathophysiological mechanisms of nephrotoxicity include direct intrarenal vasoconstriction, acute tubular necrosis, acute interstitial nephritis and tubular obstruction less frequently. Enalapril an inhibitor of angiotensin converting enzyme, is used in a variety of cardiovascular and renal diseases. The experience with this medication in infants is small, has several side effects, among these the most important is the alteration of renal function due to a decrease in both renal perfusion due to hypotension, as a drop in glomerular filtration fraction and direct nephrotoxic effect. We describe a case of acute renal failure possibly associated with the use of enalapril in a preterm newborn and performing a literature review.

Keywords : Birth; preterm; Acute renal failure; Inhibitors of angiotensin converting enzyme.

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