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Reducing Mortality in Acute Kidney Injury pp 107–112Cite as

Fenoldopam and Acute Kidney Injury: Is It Time to Turn the Page?

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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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Authors and Affiliations

  1. Cardiac Anesthesia and Intensive Care Unit, A.O.R.N. “Dei Colli” – Monaldi Hospital, via L. Bianchi, Naples, 80131, Italy

    Antonio Pisano MD & Nicola Galdieri MD

  2. Department of Critical Care, A.O.R.N. “Dei Colli”, via L. Bianchi, Naples, 80131, Italy

    Antonio Corcione MD

Authors
  1. Antonio Pisano MD
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  2. Nicola Galdieri MD
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  3. Antonio Corcione MD
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Corresponding author

Correspondence to Antonio Pisano MD .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy

    Giovanni Landoni

  2. Cardiac Anesthesia & ICU, AORN Dei Colli, Monaldi Hospital Cardiac Anesthesia & ICU, Naples, Italy

    Antonio Pisano

  3. IRCCS San Raffaele Scientific Institute, Dept of Anesthesia & Intensive care, Milano, Milano, Italy

    Alberto Zangrillo

  4. Austin Hospital, Heidelberg, Victoria, Australia

    Rinaldo Bellomo

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© 2016 Springer International Publishing Switzerland

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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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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33427-1

  • Online ISBN: 978-3-319-33429-5

  • eBook Packages: MedicineMedicine (R0)

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