Fenoldopam and renal hemodynamics in shiga toxin-related hemolytic uremic syndrome

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.