title: Fenoldopam to prevent renal replacement therapy after cardiac surgery. Design of the FENO-HSR study.
abstract: BACKGROUND
  Acute kidney injury requiring renal replacement therapy is a serious complication following cardiac surgery associated with poor clinical outcomes. Until now no drug showed nephroprotective effects. Fenoldopam is a dopamine-1 receptor agonist which seems to be effective in improving postoperative renal function. The aim of this paper is to describe the design of the FENO-HSR study, planned to assess the effect of a continuous infusion of fenoldopam in reducing the need for renal replacement therapy in patients with acute kidney injury after cardiac surgery.
  
  
  METHODS
  We're performing a double blind, placebo-controlled multicentre randomized trial in over 20 Italian hospitals. Patients who develop acute renal failure defined as R of RIFLE score following cardiac surgery are randomized to receive a 96-hours continuous infusion of either fenoldopam (0.025-0.3 µg/kg/min) or placebo.
  
  
  RESULTS
  The primary endpoint will be the rate of renal replacement therapy. Secondary endpoints will be: mortality, time on mechanical ventilation, length of intensive care unit and hospital stay, peak serum creatinine and the rate of acute renal failure (following the RIFLE score).
  
  
  CONCLUSIONS
  This trial is planned to assess if fenoldopam could improve relevant outcomes in patients undergoing cardiac surgery who develop acute renal dysfunction. Results of this double-blind randomized trial could provide important insights to improve the management strategy of patients at high risk for postoperative acute kidney injury.
authors: Università Vita-Salute San Raffaele, Milano.
authors: G
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authors: Landoni
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authors: T
authors: Bove
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authors: D
authors: Pasero
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authors: M
authors: Comis
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authors: Orando
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authors: Pinelli
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authors: Guarracino
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authors: Corcione
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authors: Galdieri
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authors: Zucchetti
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authors: Maglioni
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authors: Biagioli
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authors: Pala
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authors: Frontini
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authors: Caramelli
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authors: Persi
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authors: Renzini
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authors: Paoletti
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authors: Lorini
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authors: Morelli
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authors: Alvaro
authors: R
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authors: Bianco
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authors: Pittarello
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authors: Manzato
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authors: Pedersini
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authors: Mizzi
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authors: Lojacono
authors: P
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authors: Leoncini
authors: T
authors: T
authors: Iovino
authors: C
authors: C
authors: Cariello
authors: R
authors: R
authors: Baldassarri
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authors: AM
authors: Camata
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authors: Padua
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authors: Frascaroli
authors: S
authors: S
authors: Leonardi
authors: E
authors: E
authors: Bignami
authors: A
authors: A
authors: Zangrillo
keywords: acute renal failure; anesthesia; cardiac surgery; cardiac surgical procedures; fenoldopam; renal replacement therapy