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Fenoldopam in critically ill patients with early renal dysfunction. A crossover study.

AbstractBACKGROUND:
Acute kidney injury is a frequent problem among many critically ill patients, commonly in the context of multiple organ failure and decreased renal perfusion. Its presence conveys a poor prognosis. Currently, effective therapeutic interventions are limited and dopaminergic agonists have been suggested as an option to prevent further damage.
METHODS:
We performed a randomized, double-blinded, prospective crossover study in 17 patients admitted to our trauma intensive care unit (ICU) with evidence of impaired renal function. Patients were randomized to a 24-h intravenous infusion of low-dose fenoldopam or placebo. When the infusion of fenoldopam or placebo was completed, patients underwent a 24-h "washout" period in which no study intervention was performed. This sequence was repeated in each patient with the opposite agent, so each patient served as his own control. Four-hour creatinine collections were taken during the last 4 h of each infusion and washout periods to determine creatinine clearance changes during and after the administration of the study drug.
RESULTS:
The creatinine clearance was higher with fenoldopam infusion than with placebo infusion (P = 0.045). The FENa was not significantly different.
CONCLUSIONS:
Our study showed that low-dose Fenoldopam increases creatinine clearance in the critically ill with renal insufficiency. Fenoldopam may be a useful drug in ICU patients with early renal dysfunction.
AuthorsMiguel Cobas, Gian Paparcuri, Maria De La Pena, Gaston Cudemus, Erik Barquist, Albert Varon
JournalCardiovascular therapeutics (Cardiovasc Ther) Vol. 29 Issue 4 Pg. 280-4 (Aug 2011) ISSN: 1755-5922 [Electronic] England
PMID20955210 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Copyright© 2010 Blackwell Publishing Ltd.
Chemical References
  • Dopamine Agonists
  • Fenoldopam
Topics
  • Acute Kidney Injury (drug therapy, physiopathology)
  • Adult
  • Aged
  • Critical Illness
  • Cross-Over Studies
  • Dopamine Agonists (therapeutic use)
  • Double-Blind Method
  • Fenoldopam (therapeutic use)
  • Humans
  • Middle Aged
  • Prospective Studies

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