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Fenoldopam in critically ill patients with early renal dysfunction. A crossover study.

Author(s): Cobas M, Paparcuri G, De La Pena M, Cudemus G, Barquist E, Varon A

Affiliation(s): Department of Anesthesiology, Perioperative Medicine and Pain Management, Leonard M. Miller School of Medicine, University of Miami, FL, USA.

Publication date & source: 2011-08, Cardiovasc Ther., 29(4):280-4. Epub 2010 Oct 18.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

BACKGROUND: Acute kidney injury is a frequent problem among many critically ill patients, commonly in the context of multiple organ failure and decreased renal perfusion. Its presence conveys a poor prognosis. Currently, effective therapeutic interventions are limited and dopaminergic agonists have been suggested as an option to prevent further damage. METHODS: We performed a randomized, double-blinded, prospective crossover study in 17 patients admitted to our trauma intensive care unit (ICU) with evidence of impaired renal function. Patients were randomized to a 24-h intravenous infusion of low-dose fenoldopam or placebo. When the infusion of fenoldopam or placebo was completed, patients underwent a 24-h "washout" period in which no study intervention was performed. This sequence was repeated in each patient with the opposite agent, so each patient served as his own control. Four-hour creatinine collections were taken during the last 4 h of each infusion and washout periods to determine creatinine clearance changes during and after the administration of the study drug. RESULTS: The creatinine clearance was higher with fenoldopam infusion than with placebo infusion (P = 0.045). The FENa was not significantly different. CONCLUSIONS: Our study showed that low-dose Fenoldopam increases creatinine clearance in the critically ill with renal insufficiency. Fenoldopam may be a useful drug in ICU patients with early renal dysfunction. (c) 2010 Blackwell Publishing Ltd.

Page last updated: 2011-12-09

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