Pathophysiology of radiocontrast nephropathy and use of fenoldopam for its prevention.
There are no proven therapeutic agents for the prevention or treatment of acute renal failure. Radiocontrast agents induce intense vasoconstriction in the renal medulla, which is hypoxic even in normal physiologic states, thereby aggravating the imbalance of medullary oxygen supply and demand. Fenoldopam specifically increases blood flow to the renal medulla through selective agonism of dopamine-1 receptors and has been found to prevent radiocontrast nephropathy in several investigations, including one randomized, double-blind, placebo-controlled trial.
Mathur
V S
VS
Departments of Nephrology and Transplantation, University of California, San Francisco, CA, USA.
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D018491:Dopamine Agonists / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D018818:Fenoldopam / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007677:Kidney Function Tests; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D012079:Renal Circulation / Q000187:drug effects; D012680:Sensitivity and Specificity
D003287:Contrast Media; D018491:Dopamine Agonists; D019275:Radiopharmaceuticals; D018818:Fenoldopam