Intravenous Fenoldopam for Early Acute Kidney Injury After Liver Transplantation

Overview

Journal J Anesth

Specialty Anesthesiology

Date 2014 Dec 1

PMID 25433498

Citations 3

Authors

Gianni Biancofiore

Maria L Bindi

Mario Miccoli

Elisabetta Cerutti

Bruna Lavezzo

Laura Pucci

Massimo Bisa

Massimo Esposito

Luca Meacci

Roberto Mozzo

Chiara Stratta

Giuseppe Penno

Angelo Baggiani

Franco Filipponi

Affiliations

Soon will be listed here.

Abstract

Purpose: Acute kidney injury remains a serious complication after orthotopic liver transplantation. To date, several 'renal-protective' agents have been explored in this setting but with conflicting and disappointing results. Therefore, our aim is to evaluate the effects of fenoldopam in liver transplant patients with an established renal injury.

Methods: In this prospective study, intravenous fenoldopam 0.1 µg/kg/min was administered to consecutive liver transplant patients with postoperative (within 7 days from surgery) stage 2 acute kidney injury (AKI) according to the Acute Kidney Injury Network classification. Actual glomerular filtration rate (GFR; calculated by the iohexol plasma clearance), serum creatinine (SCr) and cystatin C (SCyC) were used to assess the effect of the medication on the patients.

Results: During the study, 295 patients underwent liver transplant. Fifty-one patients (17.6%) met the inclusion criteria and the data from 48 patients were analysed. SCr and SCyC levels decreased (p < 0.001 after 48 h; p < 0.0001 after 72 h) and GFR increased (p < 0.001 after 24 h; p < 0.0001 after 72 h). When compared to a cohort of comparable patients with AKI from our historical series, the patients in the present study showed better SCr and SCyC levels. It was not necessary to discontinue the infusion of fenoldopam in any patient because of the occurrence of adverse events potentially attributable to it.

Conclusion: We showed that fenoldopam was capable of improving some renal function parameters in postoperative liver transplantation patients with on-going AKI. This preliminary study now sets the stage for a multicenter, randomized, placebo-controlled trial in order to provide definite evidence.

Citing Articles

A positive-negative switching LC-MS/MS method for quantification of fenoldopam and its phase II metabolites: Applications to a pharmacokinetic study in rats.

Du T, Sun R, Siddiqui N, Moatamed L, Zhang Y, Liang D J Chromatogr B Analyt Technol Biomed Life Sci. 2021; 1179:122854.

PMID: 34242859 PMC: 8403159. DOI: 10.1016/j.jchromb.2021.122854.

Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis.

Thongprayoon C, Kaewput W, Thamcharoen N, Bathini T, Watthanasuntorn K, Lertjitbanjong P J Clin Med. 2019; 8(3).

PMID: 30884912 PMC: 6463182. DOI: 10.3390/jcm8030372.

Intravenous fenoldopam for acute kidney injury.

Liu Y, Xue F, Li R J Anesth. 2015; 29(6):979.

PMID: 26242585 DOI: 10.1007/s00540-015-2059-z.

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