title: Fenoldopam and renal function after partial nephrectomy in a solitary kidney: a randomized, blinded trial.
abstract: OBJECTIVE
  To test the hypothesis that fenoldopam administration ameliorates ischemic injury, preserving the glomerular filtration rate and serum creatinine postoperatively after partial nephrectomy in patients with a solitary kidney.
  
  
  METHODS
  Fenoldopam is a short-acting dopamine-1 receptor agonist that might provide renal protection during ischemic stress. A total of 90 patients with a solitary functioning kidney who were undergoing partial nephrectomy were randomized to fenoldopam or placebo in a double-blind protocol. The patients assigned to fenoldopam received an infusion rate of 0.1 μg/kg/min for 24 hours. The effect of fenoldopam on renal function was assessed by comparing the groups on the change in glomerular filtration rate from baseline to the third postoperative day (primary outcome) and on the change in serum creatinine over time (secondary outcome).
  
  
  RESULTS
  Of the 90 enrolled patients, 77 provided analyzable data (43 in fenoldopam and 44 in placebo group). Fenoldopam (vs placebo) did not reduce the mean percentage of change in the glomerular filtration rate from baseline to the third postoperative day (P = .15), with an estimated ratio of means of 0.89 (95% confidence interval 0.69-1.09) for fenoldopam vs placebo. The postoperative serum creatinine in the 2 groups changed at comparable rates from postoperative day 1 to 4 (group-by-time interaction, P = .72) after adjusting for baseline creatinine, with no difference in the mean serum creatinine over time (P = .78).
  
  
  CONCLUSIONS
  Fenoldopam administration did not preserve renal function in the clinical setting of renal ischemia during solitary partial nephrectomy, as evidenced by changes in the glomerular filtration rate or serum creatinine.
authors: Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH 44195, USA. oharaj@ccf.org
authors: Jerome F
authors: JF
authors: O'Hara
authors: Ramatia
authors: R
authors: Mahboobi
authors: Steven M
authors: SM
authors: Novak
authors: Angela M
authors: AM
authors: Bonilla
authors: Edward J
authors: EJ
authors: Mascha
authors: Amr F
authors: AF
authors: Fergany
authors: Steven C
authors: SC
authors: Campbell
authors: Jihad H
authors: JH
authors: Kaouk
authors: Kristina M
authors: KM
authors: Kaple
authors: Inderbir S
authors: IS
authors: Gill
authors: Stephanie A
authors: SA
authors: Ziegman
authors: Daniel I
authors: DI
authors: Sessler
mesh_terms: D058186:Acute Kidney Injury / Q000503:physiopathology* / Q000517:prevention & control; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D018491:Dopamine Agonists / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D018818:Fenoldopam / Q000494:pharmacology* / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects; D015427:Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control; D018709:Statistics, Nonparametric
chemical_list: D018491:Dopamine Agonists; D003404:Creatinine; D018818:Fenoldopam