Fenoldopam Mesylate for the Prevention of Contrast Induced Nephropathy

Abstract

A randomized controlled multicenter trail was conducted to determine the efficacy of fenoldopam mesylate in preventing contrast nephropathy after invasive cardiovascular procedures. The study measured serum creatinine levels at baseline and at 1, 24, 48 and 72 to 96 hours after drug administration. Patients (N = 315) with serum creatinine clearance of less than 60 mL/min were randomized to receive fenoldopam mesylate (n = 157) or placebo (n = 158). Twenty-eight centers participated in the study. Intravenous fenoldopam (0.05 gg/kg/min, titrated to 0.10 gg/kg/min) (or placebo) was started 1 hour prior to angiography and was continued for 12 hours. The endpoint of contrast-induced nephropathy occurred in 33.6% of the patients assigned to receive fenoldopam compared with 30.1% of patients who received the placebo. The difference in the 30-day death rate, need for dialysis, or rehospitalization between the two groups was not significant. The study concluded that fenoldopam mesylate does not prevent further renal deterioration after contrast administration in patients with chronic renal insufficiency.