Beneficial Effect of Intrarenal Verapamil in Human Acute Renal Failure

Cellular Ca2+ influx during the reperfusion period after an ischemic insult has been proposed to be a crucial pathogenetic factor in the development of experimental acute renal failure (ARF). The present study, therefore, examined the potential beneficial effect of intrarenal verapamil, a calcium entry blocking agent, on ARF in patients. Twelve patients were enrolled in the study. Six ARF patients (experimental group)-ARF caused by malaria (4 patients) and leptospirosis (2 patients)-had a catheter placed in their renal artery; verapamil was infused at 100 μg/minfor 3 h and intravenous furosemide, 0.8 mg/kg/h x 24 h was also administered. Another six ARF patients (control group)-ARF caused by malaria (5 patients) and leptospirosis (1 patient)-were treated with intravenous furosemide alone. Baseline renal function was comparable in both groups; GFR (3.16 ± 3.24 vs 0.7 ± 1.5 mL/min, NS), serum creatinine (Scr), (9.1 ± 2.1 vs 11.3 ± 2.2 mg/dL, NS), and urine volume (V) (41.79 ± 4.77vs 34.54 ± 13.52 mL/h, NS), were comparable in the experimental and control groups. Twenty-four hours posttreatment, the increment of GFR (9.66 ±4.25 vs 1.32 ± 0.50mL/min, P