pituitrin and Amyloidosis

Topics: Acidosis; Acute Kidney Injury; Alkalosis; Amyloidosis; Hodgkin Disease; Humans; Hyperkalemia; Hypernatremia; Hypertension, Renal; Hypokalemia; Kidney; Kidney Concentrating Ability; Kidney Diseases; Multiple Myeloma; Neoplasms; Nephritis; Nephrotic Syndrome; Osmolar Concentration; Urine; Vasopressins; Water-Electrolyte Balance

Milrinone is a phosphodiesterase type III inhibitor with positive inotropic and vasodilatory effects. A common side effect of milrinone is hypotension from the peripheral vasodilation. Although mild elevations in serum creatinine have been described previously in the setting of milrinone-induced hypotension, acute oligoanuric renal failure requiring renal replacement therapy has not yet been described. This case report is the first to document such a result and to report the successful use of peritoneal dialysis in this setting. Previous case reports documented vasopressin as an effective alternative to catecholamines in the treatment of milrinone-induced hypotension. This report documents the use of four vasopressor agents (including vasopressin) in this patient, with only vasopressin resulting in improvement in systemic vascular resistance and blood pressure. Vasopressin may be the most effective vasopressor agent in the treatment of milrinone-induced hypotension.

Topics: Acute Kidney Injury; Adrenergic beta-Agonists; Amyloidosis; Cardiotonic Agents; Dobutamine; Drug Administration Schedule; Drug Therapy, Combination; Heart Diseases; Humans; Hypotension; Male; Middle Aged; Milrinone; Norepinephrine; Peritoneal Dialysis; Phenylephrine; Vasoconstrictor Agents; Vasodilator Agents; Vasopressins

Topics: Amyloidosis; Arginine Vasopressin; Diuresis; Familial Mediterranean Fever; Humans; Kidney Concentrating Ability; Kidney Diseases; Mannitol; Vasopressins

Topics: Adult; Amyloidosis; Humans; Inclusion Bodies; Male; Microscopy, Electron; Microscopy, Polarization; Polyneuropathies; Vasopressins