Fenoldopam and Acute Renal Failure in Cardiac Surgery: A Meta-Analysis of Randomized Placebo-Controlled Trials
Journal of Cardiothoracic and Vascular Anesthesia, 04/03/2012
Evidence Based Medicine
Zangrillo A et al. – This analysis suggests that fenoldopam reduces acute kidney injury in patients undergoing cardiac surgery. Because the number of the enrolled patients was small and there was no effect on renal replacement therapy or survival, a large, multicenter, and appropriately powered trial is needed to confirm these promising results.Methods
- A total of 440 patients from 6 studies were included in the analysis.
- he ability of fenoldopam to reduce acute kidney injury in the perioperative period when compared with placebo was investigated.
- Google Scholar and PubMed were searched (updated January 1, 2012).
- Authors and external experts were contacted.
- Pooled estimates showed that fenoldopam consistently and significantly reduced the risk of acute kidney injury (odds ratio [OR]=0.41; 95% confidence interval [CI], 0.23–0.74; p=0.003), with a higher rate of hypotensive episodes and/or use of vasopressors (30/109 [27.5%] v 21/112 [18.8%]; OR=2.09; 95% CI, 0.98–4.47; p=0.06) and no effect on renal replacement therapy, survival, and length of intensive care unit or hospital stay.