Cochrane Database Syst Rev
Fenoldopam shows promise in reducing acute kidney injury risk
Study design: This systematic review and meta-analysis included 25 randomized controlled trials involving 3,339 participants. The studies compared fenoldopam with placebo, saline, and other active medications (dopamine and N-acetylcysteine) for the prevention and treatment of acute kidney injury (AKI) in both adults and children.
Results: Fenoldopam was associated with a reduced risk of developing AKI in at-risk patients compared with placebo or saline (relative risk, 0.72; 95% CI 0.53-0.98). It also potentially shortened ICU stays (mean difference, -1.81 days; 95% CI -2.41 to -1.21). However, its effects on the need for renal replacement therapy (RRT) and mortality were uncertain. When compared with dopamine and N-acetylcysteine, fenoldopam showed no significant differences in preventing AKI, reducing the need for RRT, or affecting mortality rates.
Impact on clinical practice: Fenoldopam may be beneficial in reducing the incidence of AKI and ICU stay duration in at-risk patients. However, its role in treating established AKI and its comparative effectiveness against other treatments remain unclear. Further well-designed studies are needed to confirm these findings and establish clinical guidelines
Source:
Esezobor CI, et al. (2024, November 28). Cochrane Database Syst Rev. Fenoldopam for preventing and treating acute kidney injury. https://pubmed.ncbi.nlm.nih.gov/39607014/