Clinical experience with the use of fenoldopam for prevention of radiocontrast nephropathy in high-risk patients.
A protocol for using fenoldopam, an FDA-approved intravenous agent for the treatment of severe hypertension with a newly available renal vasodilatory effect, was adopted to prevent radiocontrast nephropathy in high-risk patients undergoing angiographic procedures. Fenoldopam is a selective dopamine-receptor agonist with renoprotective properties. The results of 46 consecutive procedures were retrospectively reviewed in both diabetic and nondiabetic patients and compared to a prior published cohort of similarly at-risk patients. The incidence of radiocontrast nephropathy was 13% in the group treated with fenoldopam, compared to an expected 38% based on historical controls. The percentage change in serum creatinine was also very favorable. In this clinical experience of a high-volume coronary and peripheral vascular laboratory, the use of fenoldopam in high-risk patients appeared to minimize the likelihood of radiocontrast nephropathy.
Madyoon
H
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St. Joseph's Medical Center, Stockton, CA, USA.
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D000368:Aged; D016022:Case-Control Studies; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003404:Creatinine / Q000652:urine; D003920:Diabetes Mellitus / Q000175:diagnosis; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D018818:Fenoldopam / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D012016:Reference Values; D012079:Renal Circulation / Q000187:drug effects; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D003287:Contrast Media; D018491:Dopamine Agonists; D019275:Radiopharmaceuticals; D003404:Creatinine; D018818:Fenoldopam