TY - JOUR
T1 - Fenoldopam Reduces the Incidence of Renal Replacement Therapy After Cardiac Surgery
AU - Roasio, Agostino
AU - Lobreglio, Rosetta
AU - Santin, Agostino
AU - Landoni, Giovanni
AU - Verdecchia, Claudio
PY - 2008/2
Y1 - 2008/2
N2 - Objective: To investigate whether a continuous 48-hour infusion of fenoldopam, 0.1 μg/kg/min, reduced the need for renal replacement therapy in patients with acute renal injury after cardiac surgery. Design: Case-matched study. Setting: Teaching hospital. Participants: Ninety-two patients. Interventions: Patients who developed acute renal injury (defined as serum creatinine doubling or oliguria) after cardiac surgery received a continuous infusion of fenoldopam, 0.1 μg/kg/min, (46 patients) for 48 hours. They were case matched with 46 patients who developed acute renal injury, had similar baseline characteristics, and received standard treatment (hemodynamic support to obtain a mean arterial pressure >60 mmHg, fluid administration to increase central venous pressure >10 mmHg, and loop diuretics to maintain a urine output >0.5 mL/kg/h). Renal replacement therapy was started when acute renal injury became oligoanuric, when serum creatinine increased >4 mg/dL or 3 times basal value, or in the presence of severe hyperkalemia (K >6.5 mmol/L) or severe acidemia (pH <7). Measurements and Main Results: Patients in the fenoldopam group had a reduced need for renal replacement therapy (8 patients, 17%) with respect to case-matched controls (18 patients, 39%; p = 0.037). The length of intensive care unit stay (median [interquartile range]) was similar in the 2 groups: fenoldopam group, 5 days (3-9 days), and control group, 10 days (3-16 days, p = 0.15). Conclusions: Given the limitations of case-matched studies, fenoldopam may be useful in avoiding renal replacement therapy in patients who develop acute renal injury after cardiac surgery.
AB - Objective: To investigate whether a continuous 48-hour infusion of fenoldopam, 0.1 μg/kg/min, reduced the need for renal replacement therapy in patients with acute renal injury after cardiac surgery. Design: Case-matched study. Setting: Teaching hospital. Participants: Ninety-two patients. Interventions: Patients who developed acute renal injury (defined as serum creatinine doubling or oliguria) after cardiac surgery received a continuous infusion of fenoldopam, 0.1 μg/kg/min, (46 patients) for 48 hours. They were case matched with 46 patients who developed acute renal injury, had similar baseline characteristics, and received standard treatment (hemodynamic support to obtain a mean arterial pressure >60 mmHg, fluid administration to increase central venous pressure >10 mmHg, and loop diuretics to maintain a urine output >0.5 mL/kg/h). Renal replacement therapy was started when acute renal injury became oligoanuric, when serum creatinine increased >4 mg/dL or 3 times basal value, or in the presence of severe hyperkalemia (K >6.5 mmol/L) or severe acidemia (pH <7). Measurements and Main Results: Patients in the fenoldopam group had a reduced need for renal replacement therapy (8 patients, 17%) with respect to case-matched controls (18 patients, 39%; p = 0.037). The length of intensive care unit stay (median [interquartile range]) was similar in the 2 groups: fenoldopam group, 5 days (3-9 days), and control group, 10 days (3-16 days, p = 0.15). Conclusions: Given the limitations of case-matched studies, fenoldopam may be useful in avoiding renal replacement therapy in patients who develop acute renal injury after cardiac surgery.
KW - acute renal failure
KW - acute renal injury
KW - cardiac surgery
KW - fenoldopam
KW - kidney
KW - renal replacement therapy
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U2 - 10.1053/j.jvca.2007.07.012
DO - 10.1053/j.jvca.2007.07.012
M3 - Article
C2 - 18249326
AN - SCOPUS:38749144383
VL - 22
SP - 23
EP - 26
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 1
ER -