Fenoldopam Reduces the Need for Renal Replacement Therapy and In-Hospital Death in Cardiovascular Surgery: A Meta-Analysis

Giovanni Landoni, Giuseppe G L Biondi-Zoccai, Giovanni Marino, Tiziana Bove, Oliviero Fochi, Giulia Maj, Maria Grazia Calabrò, Imad Sheiban, James A. Tumlin, Marco Ranucci, Alberto Zangrillo

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

Objective: Acute renal failure is a common and threatening complication in patients undergoing cardiovascular surgery. To determine the efficacy of fenoldopam in the prevention of acute renal failure, the authors performed a systematic review of randomized, controlled trials and propensity-matched studies in patients undergoing cardiovascular surgery. Design: Meta-analysis. Setting: Hospitals. Participants: A total of 1,059 patients from 13 randomized and case-matched studies were included in the analysis. Interventions: None. Measurements and Main Results: Google Scholar, PubMed, and scientific sessions were searched (updated November 2006). Authors and external experts were contacted. Four unblinded reviewers selected controlled trials that used fenoldopam in the prevention or treatment of acute renal failure in cardiovascular surgery. Four reviewers independently abstracted patient data, treatment characteristics, and outcomes. Pooled estimates showed that fenoldopam consistently and significantly reduced the need for renal replacement therapy (odds ratio = 0.37 [0.23-0.59], p <0.001) and in-hospital death (odds ratio = 0.46 [0.29-0.75], p = 0.01). These benefits were associated with shorter intensive care unit stay (weighted mean difference [WMD] = -0.93 days [-1.27; -0.58], p = 0.002). Sensitivity analyses, tests for small study bias, and heterogeneity assessment further confirmed the main analysis. Conclusions: This meta-analysis provides evidence that fenoldopam may confer significant benefits in preventing renal replacement therapy and reducing mortality in patients undergoing cardiovascular surgery.

Original languageEnglish
Pages (from-to)27-33
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume22
Issue number1
DOIs
Publication statusPublished - Feb 2008

Fingerprint

Fenoldopam
Renal Replacement Therapy
Meta-Analysis
Acute Kidney Injury
Odds Ratio
PubMed
Intensive Care Units
Randomized Controlled Trials
Mortality

Keywords

  • acute renal failure
  • cardiac surgery
  • diuretics
  • fenoldopam
  • kidney
  • meta-analysis
  • mortality
  • renal replacement therapy
  • vascular surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Fenoldopam Reduces the Need for Renal Replacement Therapy and In-Hospital Death in Cardiovascular Surgery : A Meta-Analysis. / Landoni, Giovanni; Biondi-Zoccai, Giuseppe G L; Marino, Giovanni; Bove, Tiziana; Fochi, Oliviero; Maj, Giulia; Calabrò, Maria Grazia; Sheiban, Imad; Tumlin, James A.; Ranucci, Marco; Zangrillo, Alberto.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 22, No. 1, 02.2008, p. 27-33.

Research output: Contribution to journalArticle

Landoni, Giovanni ; Biondi-Zoccai, Giuseppe G L ; Marino, Giovanni ; Bove, Tiziana ; Fochi, Oliviero ; Maj, Giulia ; Calabrò, Maria Grazia ; Sheiban, Imad ; Tumlin, James A. ; Ranucci, Marco ; Zangrillo, Alberto. / Fenoldopam Reduces the Need for Renal Replacement Therapy and In-Hospital Death in Cardiovascular Surgery : A Meta-Analysis. In: Journal of Cardiothoracic and Vascular Anesthesia. 2008 ; Vol. 22, No. 1. pp. 27-33.
@article{2a1ed3ce7849406c9731a6292ec2a3fe,
title = "Fenoldopam Reduces the Need for Renal Replacement Therapy and In-Hospital Death in Cardiovascular Surgery: A Meta-Analysis",
abstract = "Objective: Acute renal failure is a common and threatening complication in patients undergoing cardiovascular surgery. To determine the efficacy of fenoldopam in the prevention of acute renal failure, the authors performed a systematic review of randomized, controlled trials and propensity-matched studies in patients undergoing cardiovascular surgery. Design: Meta-analysis. Setting: Hospitals. Participants: A total of 1,059 patients from 13 randomized and case-matched studies were included in the analysis. Interventions: None. Measurements and Main Results: Google Scholar, PubMed, and scientific sessions were searched (updated November 2006). Authors and external experts were contacted. Four unblinded reviewers selected controlled trials that used fenoldopam in the prevention or treatment of acute renal failure in cardiovascular surgery. Four reviewers independently abstracted patient data, treatment characteristics, and outcomes. Pooled estimates showed that fenoldopam consistently and significantly reduced the need for renal replacement therapy (odds ratio = 0.37 [0.23-0.59], p <0.001) and in-hospital death (odds ratio = 0.46 [0.29-0.75], p = 0.01). These benefits were associated with shorter intensive care unit stay (weighted mean difference [WMD] = -0.93 days [-1.27; -0.58], p = 0.002). Sensitivity analyses, tests for small study bias, and heterogeneity assessment further confirmed the main analysis. Conclusions: This meta-analysis provides evidence that fenoldopam may confer significant benefits in preventing renal replacement therapy and reducing mortality in patients undergoing cardiovascular surgery.",
keywords = "acute renal failure, cardiac surgery, diuretics, fenoldopam, kidney, meta-analysis, mortality, renal replacement therapy, vascular surgery",
author = "Giovanni Landoni and Biondi-Zoccai, {Giuseppe G L} and Giovanni Marino and Tiziana Bove and Oliviero Fochi and Giulia Maj and Calabr{\`o}, {Maria Grazia} and Imad Sheiban and Tumlin, {James A.} and Marco Ranucci and Alberto Zangrillo",
year = "2008",
month = "2",
doi = "10.1053/j.jvca.2007.07.015",
language = "English",
volume = "22",
pages = "27--33",
journal = "Journal of Cardiothoracic and Vascular Anesthesia",
issn = "1053-0770",
publisher = "W B SAUNDERS CO-ELSEVIER INC",
number = "1",

}

TY - JOUR

T1 - Fenoldopam Reduces the Need for Renal Replacement Therapy and In-Hospital Death in Cardiovascular Surgery

T2 - A Meta-Analysis

AU - Landoni, Giovanni

AU - Biondi-Zoccai, Giuseppe G L

AU - Marino, Giovanni

AU - Bove, Tiziana

AU - Fochi, Oliviero

AU - Maj, Giulia

AU - Calabrò, Maria Grazia

AU - Sheiban, Imad

AU - Tumlin, James A.

AU - Ranucci, Marco

AU - Zangrillo, Alberto

PY - 2008/2

Y1 - 2008/2

N2 - Objective: Acute renal failure is a common and threatening complication in patients undergoing cardiovascular surgery. To determine the efficacy of fenoldopam in the prevention of acute renal failure, the authors performed a systematic review of randomized, controlled trials and propensity-matched studies in patients undergoing cardiovascular surgery. Design: Meta-analysis. Setting: Hospitals. Participants: A total of 1,059 patients from 13 randomized and case-matched studies were included in the analysis. Interventions: None. Measurements and Main Results: Google Scholar, PubMed, and scientific sessions were searched (updated November 2006). Authors and external experts were contacted. Four unblinded reviewers selected controlled trials that used fenoldopam in the prevention or treatment of acute renal failure in cardiovascular surgery. Four reviewers independently abstracted patient data, treatment characteristics, and outcomes. Pooled estimates showed that fenoldopam consistently and significantly reduced the need for renal replacement therapy (odds ratio = 0.37 [0.23-0.59], p <0.001) and in-hospital death (odds ratio = 0.46 [0.29-0.75], p = 0.01). These benefits were associated with shorter intensive care unit stay (weighted mean difference [WMD] = -0.93 days [-1.27; -0.58], p = 0.002). Sensitivity analyses, tests for small study bias, and heterogeneity assessment further confirmed the main analysis. Conclusions: This meta-analysis provides evidence that fenoldopam may confer significant benefits in preventing renal replacement therapy and reducing mortality in patients undergoing cardiovascular surgery.

AB - Objective: Acute renal failure is a common and threatening complication in patients undergoing cardiovascular surgery. To determine the efficacy of fenoldopam in the prevention of acute renal failure, the authors performed a systematic review of randomized, controlled trials and propensity-matched studies in patients undergoing cardiovascular surgery. Design: Meta-analysis. Setting: Hospitals. Participants: A total of 1,059 patients from 13 randomized and case-matched studies were included in the analysis. Interventions: None. Measurements and Main Results: Google Scholar, PubMed, and scientific sessions were searched (updated November 2006). Authors and external experts were contacted. Four unblinded reviewers selected controlled trials that used fenoldopam in the prevention or treatment of acute renal failure in cardiovascular surgery. Four reviewers independently abstracted patient data, treatment characteristics, and outcomes. Pooled estimates showed that fenoldopam consistently and significantly reduced the need for renal replacement therapy (odds ratio = 0.37 [0.23-0.59], p <0.001) and in-hospital death (odds ratio = 0.46 [0.29-0.75], p = 0.01). These benefits were associated with shorter intensive care unit stay (weighted mean difference [WMD] = -0.93 days [-1.27; -0.58], p = 0.002). Sensitivity analyses, tests for small study bias, and heterogeneity assessment further confirmed the main analysis. Conclusions: This meta-analysis provides evidence that fenoldopam may confer significant benefits in preventing renal replacement therapy and reducing mortality in patients undergoing cardiovascular surgery.

KW - acute renal failure

KW - cardiac surgery

KW - diuretics

KW - fenoldopam

KW - kidney

KW - meta-analysis

KW - mortality

KW - renal replacement therapy

KW - vascular surgery

UR - http://www.scopus.com/inward/record.url?scp=38749150604&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38749150604&partnerID=8YFLogxK

U2 - 10.1053/j.jvca.2007.07.015

DO - 10.1053/j.jvca.2007.07.015

M3 - Article

C2 - 18249327

AN - SCOPUS:38749150604

VL - 22

SP - 27

EP - 33

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

IS - 1

ER -