Abstract
The use of low-dose dopamine for renal protection has been firstly described more than 50 years ago and has tenaciously resisted until recently. However, it is now clear that this intervention is, on average, not effective for prevention or early treatment of acute kidney injury (AKI) and may even be harmful. Nevertheless, a new enthusiasm has developed during the last decade for a possible nephroprotective action of fenoldopam, a specific dopamine type-1 receptor agonist with a renal action similar to that of low-dose dopamine, but theoretically more favorable and without the adverse effects related to systemic adrenergic stimulation. Fenoldopam remained, until recently, one of the few drugs which were thought to have a potential beneficial effect on renal function, as well as on outcome, in critically ill patients with or at risk for AKI. However, the largest multicenter randomized controlled trial addressing the impact of fenoldopam on the need for renal replacement therapy and on mortality in patients with early cardiac surgery-associated AKI, recently published, seriously questioned the effectiveness (and also the safety) of this strategy.
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References
Friedrich JO, Adhikari N, Herridge MS et al (2005) Meta-analysis: low-dose dopamine increases urine output but does not prevent renal dysfunction or death. Ann Intern Med 142(7):510–524
Landoni G, Baiardo Redaelli M, Pisano A (2016) Dopamine derivatives and acute kidney injury: the search for the magic bullet continues… and leads to new (magic?) targets. Nephrol Dial Transplant 31(4):512–514
Shaw A (2012) Update on acute kidney injury after cardiac surgery. J Thorac Cardiovasc Surg 143(3):676–681
Winkelmayer WC, Finkel KW (2014) Prevention of acute kidney injury using vasoactive or antiplatelet treatment: three strikes and out? JAMA 312(21):2221–2222
Kellum JA, Lameire N, KDIGO AKI Guideline Work Group (2013) Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (part 1). Crit Care 17(1):204
Argalious M, Motta P, Khandwala F et al (2005) “Renal dose” dopamine is associated with the risk of new-onset atrial fibrillation after cardiac surgery. Crit Care Med 33:1327–1332
Murray PT (2006) Fenoldopam: renal-dose dopamine redux? Crit Care Med 34(3):910–911
Bove T, Zangrillo A, Guarracino F et al (2014) Effect of fenoldopam on use of renal replacement therapy among patients with acute kidney injury after cardiac surgery: a randomized clinical trial. JAMA 312(21):2244–2253
Landoni G, Biondi-Zoccai GG, Tumlin JA et al (2007) Beneficial impact of fenoldopam in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials. Am J Kidney Dis 49(1):56–68
Landoni G, Biondi-Zoccai GG, Marino G et al (2008) Fenoldopam reduces the need for renal replacement therapy and in-hospital death in cardiovascular surgery: a meta-analysis. J Cardiothorac Vasc Anesth 22:27–33
Landoni G, Bove T, Székely A et al (2013) Reducing mortality in acute kidney injury patients: systematic review and international web-based survey. J Cardiothorac Vasc Anesth 27(6):1384–1398
Landoni G, Augoustides JG, Guarracino F et al (2011) Mortality reduction in cardiac anesthesia and intensive care: results of the first international consensus conference. HSR Proc Intensive Care Cardiovasc Anesth 3(1):9–19
Mao H, Katz N, Ariyanon W et al (2013) Cardiac surgery-associated acute kidney injury. Cardiorenal Med 3(3):178–199
Zangrillo A, Biondi-Zoccai GG, Frati E et al (2012) Fenoldopam and acute renal failure in cardiac surgery: a meta-analysis of randomized placebo-controlled trials. J Cardiothorac Vasc Anesth 26(3):407–413
Bellomo R, Ronco C, Kellum JA et al (2004) Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the Acute Dialysis Quality Initiative (ADQI) group. Crit Care 8:R204–R212
Legrand M, Darmon M, Joannidis M (2015) Fenoldopam and acute kidney injury. JAMA 313(9):970–971
Bove T, Landoni G, Calabrò MG et al (2005) Renoprotective action of fenoldopam in high-risk patients undergoing cardiac surgery: a prospective, double-blind, randomized clinical trial. Circulation 111(24):3230–3235
Meco M, Cirri S (2010) The effect of various fenoldopam doses on renal perfusion in patients undergoing cardiac surgery. Ann Thorac Surg 89(2):497–503
Choi MR, Kouyoumdzian NM, Rukavina Mikusic NL et al (2015) Renal dopaminergic system: pathophysiological implications and clinical perspectives. World J Nephrol 4(2):196–212
Varon J, Marik PE (2003) Clinical review: the management of hypertensive crises. Crit Care 7(5):374–384
Parolari A, Pesce LL, Pacini D et al (2012) Risk factors for perioperative acute kidney injury after adult cardiac surgery: role of perioperative management. Ann Thorac Surg 93(2):584–591
Bagshaw SM, George C, Bellomo R (2008) Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care 12:R47
Glodowski SD, Wagener G (2015) New insights into the mechanisms of acute kidney injury in the intensive care unit. J Clin Anesth 27:175–180
Ishimoto Y, Inagi R (2015) Mitochondria: a therapeutic target in acute kidney injury. Nephrol Dial Transplant. pii: gfv317 [Epub ahead of print]
Tábara LC, Poveda J, Martin-Cleary C et al (2014) Mitochondria-targeted therapies for acute kidney injury. Expert Rev Mol Med 16:e13
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Pisano, A., Galdieri, N., Corcione, A. (2016). Fenoldopam and Acute Kidney Injury: Is It Time to Turn the Page?. In: Landoni, G., Pisano, A., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Acute Kidney Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-33429-5_13
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DOI: https://doi.org/10.1007/978-3-319-33429-5_13
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