Nesiritide therapy in a term neonate with renal disease
Abstract
A term (39-wk-old) male neonate exhibited respiratory distress and anuria within 2 days of birth. The patient was diagnosed with pulmonary hypertension, polycystic kidney disease, and heart failure; his initial B-type natriuretic peptide concentration was 2460 pg/ml. After minimal response to loop diuretics, the patient was given an infusion of nesiritide 0.01 μg/kg/minute, with no loading dose. Urine output increased over 400%, and cardiac function improved. Nesiritide was titrated to 0.03 μg/kg/minute with no hypotension, decreased renal function, or adverse cardiac sequelae over the next 6 days. No subsequent changes in cardiac function occurred during the infant's stay in a progressive care unit, but he died at age 5.5 months due to sepsis. This case report demonstrates the successful first use of nesiritide therapy in a neonate with renal disease. Further studies are warranted to evaluate the safety and administration of this agent in the neonatal patient population.
Publication Title
Pharmacotherapy
Recommended Citation
Moffett, B., Jefferies, J., Rossano, J., & Towbin, J. (2006). Nesiritide therapy in a term neonate with renal disease. Pharmacotherapy, 26 (2), 281-284. https://doi.org/10.1592/phco.26.2.281
