A comparison between fenoldopam and low-dose dopamine in early renal dysfunction of critically ill patients*

Brienza, Nicola; Malcangi, Vincenzo; Dalfino, Lidia; Trerotoli, Paolo; Guagliardi, Clementina; Bortone, Dora; Faconda, Giuseppe; Ribezzi, Mario; Ancona, Giovanni; Bruno, Francesco; Fiore, Tommaso

doi:10.1097/01.ccm.0000201884.08872.a2

Cited by 99 publications

(46 citation statements)

References 43 publications

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“…Seven studies have included 1218 patients and did not find beneficial effects associated with the preventive or curative administration of fenoldopam as concerns mortality and the need for RRT [174][175][176][177][178][179][180]. The benefit of fenoldopam in terms of AKI occurrence is difficult to evaluate due to heterogenous delays in administration and diagnosis criteria among studies.…”

Section: Rationalementioning

confidence: 99%

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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Acute kidney injury (AKI) is a syndrome that has progressed a great deal over the last 20 years. The decrease in urine output and the increase in classical renal biomarkers, such as blood urea nitrogen and serum creatinine, have largely been used as surrogate markers for decreased glomerular filtration rate (GFR), which defines AKI. However, using such markers of GFR as criteria for diagnosing AKI has several limits including the difficult diagnosis of non-organic AKI, also called "functional renal insufficiency" or "pre-renal insufficiency". This situation is characterized by an oliguria and an increase in creatininemia as a consequence of a reduction in renal blood flow related to systemic haemodynamic abnormalities. In this situation, "renal insufficiency" seems rather inappropriate as kidney function is not impaired. On the contrary, the kidney delivers an appropriate response aiming to recover optimal systemic physiological haemodynamic conditions. Considering the kidney as insufficient is erroneous because this suggests that it does not work correctly, whereas the opposite is occurring, because the kidney is healthy even in a threatening situation. With current definitions of AKI, normalization of volaemia is needed before defining AKI in order to avoid this pitfall.

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Section: Rationalementioning

confidence: 99%

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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“…Our results are in accordance with only two previous reports in which fenoldopam was used at a low dosage (9) or for a short period of time. (10) All the other studies (7,8,(13)(14)(15)(16)(17)(18)(19)(20) …”

Section: Discussionmentioning

confidence: 99%

Perioperative fenoldopam for the prevention of acute renal failure in non-cardiac surgery, randomized clinical trial

Memmo

Carozzo

Landoni

et al. 2011

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“…In addition, renaldose dopamine may even worsen kidney perfusion as reflected by renal resistive indices in patients with established AKI (14). Despite early promise in pilot studies of contrast nephropathy (15,16) and sepsis-associated AKI (17,18), the selective dopamine A 1 agonist, fenoldopam, did not improve or protect kidney function in larger studies of early AKI (19) nor in contrast nephropathy (20). Low doses of atrial natriuretic peptide attenuate the rise in serum creatinine in postoperative ischemic renal failure (21) and increase urine flow rates after liver transplantation (22,23).…”

Section: Initial Consideration: Pharmacologic Interventions For Earlymentioning

confidence: 99%

Evaluation and Initial Management of Acute Kidney Injury

Himmelfarb

Joannidis²,

Molitoris

et al. 2008

Clinical Journal of the American Society of Nephrology

125

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The evaluation and initial management of patients with acute kidney injury (AKI) should include: (1) an assessment of the contributing causes of the kidney injury, (2) an assessment of the clinical course including comorbidities, (3) a careful assessment of volume status, and (4) the institution of appropriate therapeutic measures designed to reverse or prevent worsening of functional or structural kidney abnormalities. The initial assessment of patients with AKI classically includes the differentiation between prerenal, renal, and postrenal causes. The differentiation between so-called "prerenal" and "renal" causes is more difficult, especially because renal hypoperfusion may coexist with any stage of AKI. Using a modified Delphi approach, the multidisciplinary international working group, generated a set of testable research questions. Key questions included the following: Is there a difference in prognosis between volume-responsive and volume-unresponsive AKI? Are there biomarkers whose patterns (dynamic changes) predict the severity and recovery of AKI (maximal stage of AKI, need for RRT, renal recovery, mortality) and guide therapy? What is the best biomarker to assess prospectively whether AKI is volume responsive? What is the best biomarker to assess the optimal volume status in AKI patients? In evaluating the current literature and ongoing studies, it was thought that the answers to the questions posed herein would improve the understanding of AKI, and ultimately patient outcomes.

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A comparison between fenoldopam and low-dose dopamine in early renal dysfunction of critically ill patients*

Cited by 99 publications

References 43 publications

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Perioperative fenoldopam for the prevention of acute renal failure in non-cardiac surgery, randomized clinical trial

Evaluation and Initial Management of Acute Kidney Injury

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