Use of fenoldopam to prevent radiocontrast nephropathy in high-risk patients

We evaluated the ability of fenoldopam, a newly available renal vasodilator, to prevent radiocontrast nephropathy in high-risk patients undergoing interventional diagnostic and therapeutic angiographic procedures. We reviewed the results from 46 consecutive procedures in patients with serum creatinine, 1.5 mg/dL if diabetic and > 1.7 mg/dL if nondiabetic. We compared our results to a previously published cohort of similarly at-risk patients. The incidence of radiocontrast nephropathy, defined as an increase in serum creatinine of greater than or equal to 25% at 48 hr following the procedure, was 13% in the group treated with fenoldopam, compared to an expected 38%, The percentage change in serum creatinine at 48 hr was +16% vs. +118%, respectively, in the two groups. In this preliminary experience, the use of fenoldopam in high-risk patients appears to minimize the likelihood of radioncontrast nephropathy. (C) 2001 Wiley-Liss, Inc.