RenalDonorFenoldopam vs Dopamine as a Nephroprotective Strategy During Living Donor Kidney Transplantation: Preliminary Data
Section snippets
Materials and Methods
The study was performed during 2004 to 2005, after ethical committee approval and informed consent from the patients. Forty donors were enrolled in the study.
All patients were extensively studied preoperatively for kidney donation. They were all ASA I patients except for two with mild hypertension classified as ASA II. Mean age was 53 ± 6.3 years (range 41–62). All donor-recipient couples were first degree relatives (father/mother-son/daughter).
All patients were randomly divided in group F (20
Results
One patient among 20 in the group F dispayed hypotension (MAP < 75 mm Hg) independent of stopping the fenoldopam continuous infusion while three patients in group D showed tachycardia (1/20 patients HR > 120 bpm), which disappeared with reducted dopamine (2/20 patients) or stopping it (1/20 patients). Neither dobutamine nor administration of extra fluids nor esmolol use were recorded. The fluid infusion protocol was 10 ml*kg−1*h−1, and the mean infused volume did not show a significant
Discussion
Provided there is adequate volume support, an effective nephroprotective strategy should promote urine output as an indirect results of renal blood flow and glomerular filtration rate maintenance, while inducing urinary electrolyte modifications, as the result of tubular ATPase blockade. Whenever renal blood flow or glomerular filtration rate decreases, a complex neuroendocrine and humoral response triggers local and systemic hydroelectrolytic and hemodynamic changes that such to preserve
References (7)
- et al.
Fenoldopam mesylate blocks reductions in renal plasma flow after radiocontrast dye infusion: A pilot trial in the prevention of contrast nephropathy
Am Heart J
(2002) - et al.
Use of dopamine in acute renal failure: a meta-analysis
Crit Care Med
(1526) - et al.
Lack of renoprotective effects of dopamine and furosemide during cardiac surgery
J Am Soc Nephrol
(2000)
Cited by (23)
The past, present and future of the European Airway Management Society
2021, Trends in Anaesthesia and Critical CareImpact of Incidental Findings During the Evaluation of Live Kidney Donors on Post-Transplant Outcomes: A Single Center Analysis
2019, Transplantation ProceedingsLesson learnt from the abstracts of the 5th European Airway Congress 4.-7. December 2018 in Catania, Italy: Directions of learning
2018, Trends in Anaesthesia and Critical CarePharmacological Interventions in Acute Kidney Injury
2018, Chronic Kidney Disease, Dialysis, and Transplantation: A Companion to Brenner and Rector’s The KidneyAnesthetic Management of Pediatric Liver and Kidney Transplantation
2017, Anesthesiology ClinicsCitation Excerpt :Studies have shown that transplanted and denervated kidney does not respond in the same manner as native kidneys and that no improvement in graft function has been demonstrated.55 There has been some promising evidence that a fenoldopam infusion (a DA-1 receptor selective agonist) in comparison to dopamine has resulted in better graft function (diuresis and electrolyte excretion).56 At the completion of the vascular anastomosis, mannitol and furosemide are frequently administered to facilitate diuresis.
Early Postoperative ICU Care of the Kidney Transplant Recipient
2017, Kidney Transplantation, Bioengineering, and Regeneration: Kidney Transplantation in the Regenerative Medicine Era