title: Fenoldopam and acute renal failure in cardiac surgery: a meta-analysis of randomized placebo-controlled trials.
abstract: OBJECTIVE
  Because at present no pharmacologic prevention or treatment of acute kidney injury seems to be available, the authors updated a meta-analysis to investigate the effects of fenoldopam in reducing acute kidney injury in patients undergoing cardiac surgery, focusing on randomized placebo-controlled studies only.
  
  
  METHODS
  A meta-analysis of randomized, placebo-controlled trials.
  
  
  METHODS
  Hospitals.
  
  
  METHODS
  A total of 440 patients from 6 studies were included in the analysis.
  
  
  METHODS
  None. The ability of fenoldopam to reduce acute kidney injury in the perioperative period when compared with placebo was investigated.
  
  
  RESULTS
  Google Scholar and PubMed were searched (updated January 1, 2012). Authors and external experts were contacted. Pooled estimates showed that fenoldopam consistently and significantly reduced the risk of acute kidney injury (odds ratio [OR] = 0.41; 95% confidence interval [CI], 0.23-0.74; p = 0.003), with a higher rate of hypotensive episodes and/or use of vasopressors (30/109 [27.5%] v 21/112 [18.8%]; OR = 2.09; 95% CI, 0.98-4.47; p = 0.06) and no effect on renal replacement therapy, survival, and length of intensive care unit or hospital stay.
  
  
  CONCLUSIONS
  This analysis suggests that fenoldopam reduces acute kidney injury in patients undergoing cardiac surgery. Because the number of the enrolled patients was small and there was no effect on renal replacement therapy or survival, a large, multicenter, and appropriately powered trial is needed to confirm these promising results.
authors.affiliation: Department of Anesthesia, Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
authors.forename: Giuseppe G L
authors.initials: GG
authors.lastname: Biondi-Zoccai
authors.forename: Elena
authors.initials: E
authors.lastname: Frati
authors.forename: Remo Daniel
authors.initials: RD
authors.lastname: Covello
authors.forename: Luca
authors.initials: L
authors.lastname: Cabrini
authors.forename: Fabio
authors.initials: F
authors.lastname: Guarracino
authors.forename: Laura
authors.initials: L
authors.lastname: Ruggeri
authors.forename: Tiziana
authors.initials: T
authors.lastname: Bove
authors.forename: Elena
authors.initials: E
authors.lastname: Bignami
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D018818:Fenoldopam / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017582:Renal Replacement Therapy; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D018818:Fenoldopam