Fenoldopam Mesylate and Renal Function in Patients Undergoing Liver Transplantation: A Randomized, Controlled Pilot Trial
- 1 December 2004
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 99 (6), 1604-1609
- https://doi.org/10.1213/01.ane.0000136420.01393.81
Abstract
To test the relative effects on serum creatinine (CRE), blood urea nitrogen (BUN), and urine output of small-dose dopamine and fenoldopam in patients undergoing liver transplantation, we randomized 43 patients to 1 of 2 continuous infusions over 48 h, starting with anesthesia induction: fenoldopam, 0.1 microg . kg(-1) . min(-1) or dopamine, 2 microg . kg(-1) . min(-1). We used predetermined hemodynamic and intravascular volume goals (intrathoracic blood volume index 800-1000 mL/m(2), extravascular lung water index 1 mL . kg(-1) . h(-1). At postoperative day 3, the median CRE increase was 0.2 mg/dL (interquartile range [IQR] -0.2-0.5) with fenoldopam and 0.5 mg/dL (IQR 0.3-0.9, P = 0.004) in the dopamine group. The BUN increase was median 2 mg/dL (IQR -2-8) versus 8.5 mg/dL (IQR 5-12, P = 0.01), respectively, with fenoldopam versus dopamine. Urine output was similar; however, significantly fewer fenoldopam patients required furosemide compared with dopamine patients (median 1 [IQR 0-3] versus 3 [IQR 2-4], respectively, P = 0.003). The hemodynamic effects of dopamine and fenoldopam were similar. Compared with dopamine, in the setting of liver transplantation, fenoldopam is associated with better CRE and BUN values.Keywords
This publication has 24 references indexed in Scilit:
- The effects of fenoldopam on renal function in patients undergoing elective aortic surgeryEuropean Journal of Anaesthesiology, 2002
- Acute renal failure: time for consensusIntensive Care Medicine, 2001
- Fenoldopam: renal and splanchnic effects in patients undergoing coronary artery bypass graftingAnaesthesia, 2001
- Fenoldopam, a Dopamine Agonist, for Hypertensive Emergency: A Multicenter Randomized TrialAcademic Emergency Medicine, 2000
- The effects of fenoldopam, a selective dopamine receptor agonist, on systemic and renal hemodynamics in normotensive subjectsCritical Care Medicine, 1999
- Fenoldopam: a new parenteral antihypertensive: consensus roundtable on the management of perioperative hypertension and hypertensive crises.American Journal of Hypertension, 1999
- RENAL AND SYSTEMIC HEMODYNAMIC EFFECTS OF VERY-LOW DOSE FENOLDOPAM IN NORMOTENSIVE SUBJECTSAnesthesia & Analgesia, 1999
- Perioperative renal preservation: Dopexamine and fenoldopam— New agents to augment renal performanceSeminars in Anesthesia, Perioperative Medicine and Pain, 1998
- Impact of acute renal failure on mortality in end-stage liver disease with or without transplantationKidney International, 1998
- Relative DA1-Dopamine-Receptor Agonist and α-Adrenoceptor Antagonist Activity of Fenoldopam in the Anesthetized DogJournal of Cardiovascular Pharmacology, 1988