Use of Fenoldopam for Prevention of Radiocontrast Nephropathy in the Cardiac Catheterization Laboratory: A Case Series

Madyoon, Hooman; Croushore, Linda

doi:10.1111/j.1540-8183.2001.tb00731.x

Cited by 11 publications

(5 citation statements)

References 26 publications

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“…The clinical use of fenoldopam to date includes renal protection, 7,8,13,26–33 treatment of acute renal failure, 5,34,35 treatment of severe hypertension, 20,22,23,36–38 improvement of gastrointestinal oxygen delivery in hypovolemic patients, 39–44 and as a possible adjunct for congestive heart failure 45 . These uses arise from the stimulation of DA‐1 receptors in various organ systems.…”

Section: Discussionmentioning

confidence: 99%

“…These uses arise from the stimulation of DA‐1 receptors in various organ systems. Because of the selectivity of fenoldopam for DA‐1 and not DA‐2 receptors, fenoldopam is preferred over low‐dosage dopamine for these syndromes 7,29,34,39,46 . One physiologic advantage of such selective stimulation is a more favorable oxygen delivery to kidney and gastrointestinal tract in critical patients 31,40,43,44 .…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of competitive binding studies, the feline dopamine receptor has a greater affinity for the DA‐1 agonist fenoldopam than for dopamine 4 . Fenoldopam, a selective DA‐1 agonist with no α or β effects, is approved as an antihypertensive agent in humans and has been used as a renal protectant in high‐risk human patients with favorable outcomes 5–8 . Effects of fenoldopam in humans include diuresis and increased urine sodium excretion 9,10 .…”

Section: Introductionmentioning

confidence: 99%

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Diuretic effects of fenoldopam in healthy cats

Simmons¹,

Wohl²,

Schwartz

et al. 2006

J Vet Emergen Crit Care

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Objective:To determine the effect of fenoldopam infusion on urine output, sodium excretion, creatinine clearance, and indirect blood pressure in healthy cats. Design: Prospective study. Setting: Veterinary medical teaching hospital. Animals: Eight purpose-bred cats, 2-4 years old. Interventions: None. Measurements: Urine output was measured hourly for 12 hours before and after fenoldopam administration. Sodium excretion, modified creatinine clearance, and fractional sodium excretion were measured before and following fenoldopam administration. Urine specific gravity, central venous pressure, and systolic blood pressure were measured every 4 hours during the experiment.Main results: Compared with pre-infusion values, urine output, sodium excretion, and fractional excretion of sodium increased significantly 6 hours after initiation of fenoldopam infusion. This increase was sustained throughout the observation period. The modified creatinine clearance decreased significantly following 2 hours of fenoldopam infusion, but increased significantly by 6 hours after infusion, the time of peak urine output. Changes in urine specific gravity mirrored changes in fractional sodium excretion, whereas the central venous pressure mirrored changes in modified creatinine clearance. The diuretic effect in cats was prevented when a dopamine receptor blocking agent was administered before fenoldopam infusion. Conclusion: Fenoldopam at a dose of 0.5 mg/kg/min induces diuresis in cats in a delayed manner. This increase appears to be due, in part, to dopamine receptor-induced natriuresis. Changes in glomerular filtration rate may also occur. (J Vet Emerg Crit Care 2006; 16(2): 96-103)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diuretic effects of fenoldopam in healthy cats

Simmons¹,

Wohl²,

Schwartz

et al. 2006

J Vet Emergen Crit Care

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“…For this reason, it was hypothesized that fenoldopam would be beneficial for the prevention of RCN [80]. Several studies have described beneficial effects of fenoldopam, administered at the time of and following radiocontrast administration, on preventing RCN [81][82][83][84][85][86]. However, most of these studies suffered from flaws in study design and were of limited sample size.…”

Section: Fenoldopammentioning

confidence: 99%

Radiocontrast-Induced Acute Renal Failure

Weisbord

Palevsky

2005

J Intensive Care Med

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The intravascular administration of iodinated radiocontrast media can lead to acute renal dysfunction. Even small changes in renal function have been associated with increased morbidity and mortality, making the prevention of radiocontrast nephropathy of paramount importance. This review summarizes the principal risk factors for radiocontrast nephropathy and evidence-based preventive strategies that should be used to limit its occurrence. Risk factors for radiocontrast nephropathy include preexistent kidney disease, diabetes mellitus, dose of radiocontrast used, advanced congestive heart failure, and intravascular volume depletion. Proven preventive measures include volume expansion with intravenous saline or sodium bicarbonate and the use of low-osmolar or iso-osmolar radiocontrast media. Studies evaluating N-acetylcysteine have been conflicting, with meta-analyses suggesting a small beneficial effect. Studies of other pharmacologic agents have not demonstrated clinical benefit.

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“…Recent literature reviews 65,66 of this topic conclude that intravenous hydration is the treatment of choice. In addition, a recent series of case reports 68…”

Section: Diuretics Dopamine Agonists and Calcium-channel Blockersmentioning

confidence: 99%

Acute Renal Failure in Hospitalized Patients: Part II

Pruchnicki

Dasta

2002

Ann Pharmacother

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Appropriate management of ARF includes prospective identification of at-risk patients, fluid administration, and optimal hemodynamic support. Drug treatments, including low-dose dopamine and diuretics, have demonstrated extremely limited benefits and have not been shown to improve patient outcome. Experimental agents influence cellular processes of renal dysfunction and recovery; unfortunately, relatively few drugs show promise for the future.

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Use of Fenoldopam for Prevention of Radiocontrast Nephropathy in the Cardiac Catheterization Laboratory: A Case Series

Cited by 11 publications

References 26 publications

Diuretic effects of fenoldopam in healthy cats

Diuretic effects of fenoldopam in healthy cats

Radiocontrast-Induced Acute Renal Failure

Acute Renal Failure in Hospitalized Patients: Part II

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