A case series of low-dose fenoldopam in seventy cardiac surgical patients at increased risk of renal dysfunction

J Cardiothorac Vasc Anesth. 2003 Feb;17(1):17-21. doi: 10.1053/jcan.2003.5.


Objective: To evaluate the usefulness of low-dose fenoldopam mesylate in patients at risk of developing renal dysfunction after cardiac surgery requiring cardiopulmonary bypass.

Design: A prospective, single-center, observational study.

Setting: University teaching hospital.

Participants: Seventy patients scheduled for elective cardiac surgery with one or more predefined risk factors for renal dysfunction.

Interventions: After induction of anesthesia, fenoldopam (0.03 microg/kg/min) was administered throughout surgery and into the postoperative period, until the patient was stable and weaned from all other vasoactive agents. Perioperatively, fenoldopam was also used as a second-line antihypertensive agent as required.

Measurements and main results: No patient developed renal failure that required dialysis, whereas 7.1% (5/70) developed non-dialysis-dependent renal dysfunction. Four out of these 5 patients had 2 or more risk factors (9.5%). Higher preoperative creatinine levels, a history of hypertension, myocardial infarction within 5 days of surgery, and a preoperative diagnosis of chronic renal insufficiency were all good predictors of postoperative non-dialysis-dependent renal dysfunction. Discharge serum creatinine levels were lower than preoperative levels (1.16 +/- 0.36 mg/dL v 1.26 +/- 0.34 mg/dL, p < 0.05).

Conclusion: These findings suggest that renal function was preserved in patients at increased risk for renal dysfunction after cardiac surgery when low-dose fenoldopam was used in the perioperative period. However, a randomized, controlled trial is required to establish efficacy.

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiopulmonary Bypass / adverse effects*
  • Creatinine / blood
  • Dose-Response Relationship, Drug
  • Female
  • Fenoldopam / therapeutic use*
  • Humans
  • Male
  • Prospective Studies
  • Renal Insufficiency / prevention & control*
  • Risk Factors


  • Antihypertensive Agents
  • Creatinine
  • Fenoldopam