Abstract
Background
Fenoldopam, a vasodilating agent, may represent a potential therapeutic opportunity to increase renal perfusion in those conditions where renal hemodynamics are severely impaired by vascular sub-occlusion, as, indeed, is the case in thrombotic microangiopathies.
Methods
The renal resistance index (RRI) was measured, on and off fenoldopam, in 27 children with STEC-HUS.
Results
A 12% decrease in RRI was observed on fenoldopam compared to off treatment without changes in the systemic hemodynamics and with no side effects.
Conclusions
If confirmed in larger series, fenoldopam may become an important addition to supportive care to reduce ischemic damage in STEC-HUS and improve long-term outcomes.
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Acknowledgments
Following are the members of the ItalKid-HUS Network: P Accorsi (Pieve di Coriano), P Adamoli (Gravedona), N Altamura (Sesto San Giovanni), S Andreoni (Novara), M Andreotti (Desio), B Balduzzi (Esine), A Bonazza (Brescia), A Bonomini (Melzo), A Bosco (Varese), G Bossi (Pavia), E Cama (Desenzano del Garda), P Carlucci (Milano), M Casciana (Mantova), D Casnaghi (Rho), D Cattarelli (Desenzano del Garda), R Colombo (Milano), S Consolo (Milano), A Corti (Desenzano del Garda), A Dodaro (Milano), M Frediani (Milano), MR Gallina (Aosta), C Giacomazzi (Aosta), V Goj (Milano), S Grossi (Brescia), A Lepre (Crema), F Lizzoli (Magenta), S Maiandi (Lodi), MC Mancuso (Milano), C Masia (Milano), L Martelli (Bergamo), ML Melzi (Monza), E Milanesi (Cremona), A Monzani (Novara), L Napolitano (Milano), A Negri (Varese), BS Orena (Milano), B Osnaghi (Magenta), F Pagani (Brescia), F Paglialonga (Milano), L Parola (Magenta), P Pedroni (Manerbio), A Pellegatta (Busto Arsizio), M Perrone (Milano), D Picicco (Milano), G Pieri (Alessandria), S Poli (Esine), A Reciputo (Cinisello Balsamo), B Roman (Vimercate), A Rosco (Garbagnate), F Salvini (Milano), S Sardini (Asola), C Sciuto (Lecco), M Silvestri (Verbania), F Tel (Milano), S Testa (Milano), A Vigo (Ivrea), C Zambetti (Lodi).
We are thankful to “PROGETTO ALICE–ASSOCIAZIONE PER LA LOTTA ALLA SEU” for their support and continuous commitment to our research.
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Drs. Ardissino, Giussani, Capone, and Gadini conceptualized and designed the study, analyzed the results, drafted the initial manuscript, and revised and approved the final version.
Drs. Testa and Montini performed data collection, revised, and approved the final version.
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The ethical committee of our Institution provided the approval for the off-label use of fenoldopam.
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Informed consent to treatment and to the publication of the results was obtained from all parents.
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Ardissino, G., Giussani, A., Capone, V. et al. Fenoldopam and renal hemodynamics in shiga toxin-related hemolytic uremic syndrome. Pediatr Nephrol 36, 2891–2894 (2021). https://doi.org/10.1007/s00467-021-05127-3
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DOI: https://doi.org/10.1007/s00467-021-05127-3