We report here 6 cases of critically ill newborn infants with both RDS and acute renal insufficiency, unresponsive to conventional treatment (furosemide, dopamine). Theophylline, an adenosine antagonist, has been shown to prevent hypoxemia-induced renal insufficiency in rabbits and our patients thus received compassionately a low-dose of theophylline (1 mg . kg-1 i.v.). Urinary water excretion and creatinine clearances increased significantly in 5 out of 6 neonates, thus suggesting a beneficial role of theophylline in neonatal prerenal failure.