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Fenoldopam and acute renal failure in cardiac surgery: a meta-analysis of randomized placebo-controlled trials

Alberto Zangrillo1, Giuseppe G L Biondi-Zoccai, Elena Frati

  • 1Department of Anesthesia, Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy.

Journal of Cardiothoracic and Vascular Anesthesia
|March 31, 2012
PubMed
Abstract

Insights

Fenoldopam may reduce acute kidney injury (AKI) in cardiac surgery patients. However, more research is needed to confirm its effectiveness and impact on survival and renal replacement therapy.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Acute kidney injury (AKI) is a significant complication following cardiac surgery.
  • Currently, limited pharmacologic options exist for preventing or treating AKI.
  • Fenoldopam, a dopamine receptor agonist, has been investigated for its potential renal protective effects.

Purpose of the Study:

  • To conduct a meta-analysis of randomized, placebo-controlled trials to evaluate the efficacy of fenoldopam in reducing AKI in patients undergoing cardiac surgery.
  • To synthesize existing evidence on fenoldopam's impact on perioperative AKI.

Main Methods:

  • A systematic meta-analysis of randomized, placebo-controlled studies.
  • Included data from 6 studies encompassing 440 patients.
  • Searched major databases including Google Scholar and PubMed, updated January 1, 2012.

Main Results:

  • Fenoldopam significantly reduced the risk of acute kidney injury (AKI) (OR = 0.41; p = 0.003).
  • Increased rates of hypotension and vasopressor use were observed with fenoldopam.
  • No significant effect was found on renal replacement therapy, survival, or length of hospital stay.

Conclusions:

  • The meta-analysis suggests fenoldopam may be effective in reducing AKI in cardiac surgery patients.
  • However, the small sample size and lack of impact on critical outcomes necessitate larger, well-powered trials.
  • Further research is required to confirm these promising findings and establish fenoldopam's role in perioperative care.

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