Managing the high-risk patient: experience with fenoldopam, a selective dopamine receptor agonist, in prevention of radiocontrast nephropathy during percutaneous coronary intervention.
Acute worsening of renal function due to contrast agents occurs in 15% to 40% of patients with baseline renal insufficiency undergoing percutaneous coronary intervention. Radiocontrast nephropathy is associated with increased morbidity, prolonged hospitalization, and higher in-hospital mortality. Our nonrandomized data suggest that in adequately hydrated patients, the dopamine-1 receptor agonist fenoldopam is a useful adjunct during PCI for prevention of RCN, reducing its incidence to less than 5%. This renoprotective effect of fenoldopam was more pronounced in diabetics, with moderate renal failure, in whom no agent has been shown so far to be beneficial.
Kini
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Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, USA.
Sharma
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D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000188:drug therapy / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D003404:Creatinine / Q000652:urine; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D018818:Fenoldopam / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D003287:Contrast Media; D018491:Dopamine Agonists; D019275:Radiopharmaceuticals; D003404:Creatinine; D018818:Fenoldopam