Nitroprusside-induced acute azotemia.
A patient with congestive heart failure and pneumonia was begun on a nitroprusside infusion for cardiac afterload reduction. Urine output declined sharply and azotemia ensued despite little change in arterial pressure. Further evaluation supported a prerenal mechanism with dramatic recovery related to tapering and discontinuation of the nitroprusside. The mechanism of renal deterioration is possibly related to a 'steal' syndrome due to preferential dilation of vascular beds other than the renal.
Reid
G M
GM
University of Missouri, Kansas City School of Medicine.
Muther
R S
RS
D058186:Acute Kidney Injury / Q000139:chemically induced; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D005292:Ferricyanides / Q000009:adverse effects*; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D008297:Male; D009599:Nitroprusside / Q000009:adverse effects*; D014511:Uremia / Q000139:chemically induced*
D005292:Ferricyanides; D009599:Nitroprusside