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Low-dose dopamine has fallen out of favor as an intervention to prevent renal failure in critically ill patients (Journal Watch Sep 14 2001). Fenoldopam, a dopamine α-1-receptor agonist, has also been studied for this purpose (it is currently FDA-approved only for inpatient management of severe hypertension). In a meta-analysis, researchers examined the effect of fenoldopam in patients at risk for acute renal failure.
Sixteen randomized trials with 1290 patients were identified; intensive-care–unit patients and cardiac surgery patients were studied most commonly. Compared with control treatments (placebo in 11 trials and dopamine in 5), fenoldopam significantly reduced the incidence of variably defined acute renal injury (28.3% vs. 16.0%), n…