Abstract
This is a case report of an association between morphine administration and occurrence of hydronephrosis with acute renal failure. This premature female infant born at 27 weeks of gestation had moderate hydronephrosis with acute renal impairment while receiving morphine infusion for pain management after chest-tube insertion. All these findings were reversed after stopping morphine and urinary catheterization. Follow-up renal ultrasound and voiding cystourethrogram showed resolution of hydronephrosis with no evidence of vesicoureteral reflux. Morphine is associated with reversible hydronephrosis and renal impairment in premature infants.
References
Anand K (1998) Clinical importance of pain and stress in preterm neonates. Biol Neonate 73:1–9
Bouwmeester N, Hop W, van Dijk M, Anand K, van den Anker J, Tibboel D (2003) Postoperative pain in the neonate: age-related differences in morphine requirements and metabolism. Intensive Care Med 29:2009–2015
Bouwmeester N, van den Anker J, Hop W, Anand K, Tibboel D (2003) Age-and therapy-related effects on morphine requirements and plasma concentrations of morphine and its metabolites in postoperative infants. Br J Anaesth 90:642–652
Rao R, Sampers JS, Kronsberg SS, Brown JV, Desai NS, Anand KJ (2007) Neurobehavior of preterm infants at 36 weeks postconception as a function of morphine analgesia. Am J Perinatol 24:511–517
Bhandari V, Bergqvist LL, Kronsberg SS, Barton BA, Anand KJ, NEOPAIN Trial Investigators Group (2005) Morphine administration and short-term pulmonary outcomes among ventilated preterm infants. Pediatrics 116:352–359
Sherman M, Poulain F, Wootton Gorges S, Bengtsson B (2003) Urinary effects of morphine in preterm infants. Acta Paediatr 92:251–253
Das U, Sasidharan P (2001) Bladder retention of urine as a result of continuous intravenous infusion of fentanyl: 2 case reports. Pediatrics 108:1012–1015
Dray A, Metsch R (1984) Spinal opioid receptors and inhibition of urinary bladder motility in vivo. Neurosci Lett 47:81–84
Langer VS (1990) Minimal handling protocol for the intensive care nursery. Neonatal Netw 9:23–27
Saarenmaa E, Neuvonen PJ, Fellman V (2000) Gestational age and birth weight effects on plasma clearance of fentanyl in newborn infants. J Pediatr 136:767–770
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Khassawneh, M., Al-Balas, H. Renal impairment and hydronephrosis in a premature infant following morphine infusion: case report. Pediatr Nephrol 23, 1887–1888 (2008). https://doi.org/10.1007/s00467-008-0866-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-008-0866-2