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Related Experiment Videos

Preventing contrast-induced nephropathy with fenoldopam.

D W Hunter1, A Chamsuddin, H Bjarnason

  • 1Department of Radiology, MMC 292, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA.

Techniques in Vascular and Interventional Radiology
|May 1, 2002
PubMed
Summary

Fenoldopam, a dopamine variant, acts as a selective DA-1 receptor agonist, enhancing renal blood flow and sodium excretion. This orphan drug shows promise in protecting kidneys from contrast-induced nephropathy in high-risk patients.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Fenoldopam is a selective dopamine type 1 (DA-1) receptor agonist.
  • DA-1 receptors are abundant in renal and peripheral vasculature.
  • Fenoldopam induces vasodilation, increases renal blood flow, and promotes natriuresis.

Purpose of the Study:

  • To evaluate fenoldopam's potential as a renal protective agent.
  • To assess its efficacy in preventing contrast-induced nephropathy in high-risk patients.

Main Methods:

  • Intravenous fenoldopam infusion initiated pre-procedure, with dose titration based on blood pressure.
  • Administration maintained throughout procedures and post-contrast exposure.
  • Anecdotal case series of 29 high-risk patients (diabetes, renal failure) receiving fenoldopam before contrast procedures.

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Main Results:

  • Fenoldopam demonstrated potent renal protective effects in animal models, being 6 times more effective than dopamine.
  • In a small group of high-risk patients, fenoldopam was associated with a lack of contrast-induced creatinine increase.
  • The drug's clinical activity is rapid, with no rebound effect, and can be discontinued at any time.

Conclusions:

  • Fenoldopam shows promising potential as a renal protective agent, particularly for high-risk patients undergoing procedures requiring intravascular contrast.
  • Further investigation through prospective, randomized trials comparing fenoldopam with hydration is warranted to confirm its efficacy.