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01-02-2019 | Original Article

Effects of fenoldopam on renal blood flow in hypertensive chronic kidney disease

Authors: Valentina Rovella, Michele Ferrannini, Manfredi Tesauro, Giulia Marrone, Andrea Busca, Roberto Sorge, Simone Manca di Villahermosa, Maurizio Casasco, Nicola Di Daniele, Annalisa Noce

Published in: Journal of Nephrology | Issue 1/2019

Abstract

Background and aim

The synthetic drug fenoldopam mesylate (FM) may have a renoprotective role, and a “renal dose” of 0.1 µg/kg/min intravenous (IV) infusion of FM has been reported as able to increase renal blood flow without affecting systemic blood pressure. But conclusive data are still lacking. We aimed to investigate by color-Doppler ultrasonography the effects of IV administration of FM at this dosage in hypertensive chronic kidney disease (CKD) patients, and verify whether it may induce any systemic hemodynamic alteration.

Methods

In 60 hypertensive CKD patients, we measured by duplex Doppler ultrasonography, at baseline and during infusion of 0.1 µg/kg/min of FM, the systolic and diastolic flow velocity (sampled at the renal hilum, intermediate section and origin of both renal arteries) and the intra-parenchymal renal resistive index (RRI) sampled on interlobular arteries of both kidneys. Patients were divided into four subgroups (I–IV) according to classification of National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-DOQI).

Results

Infusion of 0.1 µg/kg/min FM significantly decreased the RRI (0.73 ± 0.05 vs. 0.65 ± 0.06; p < 0.0001) and increased the systolic and diastolic flow velocities in all renal artery tracts examined. No single episode of systemic hypotension was observed.

Conclusions

Very low-dose FM may significantly increase renal blood flow and exert a renal protective effect in hypertensive CKD patients. Infusion of FM at such low dosage appears also to be quite safe, even in CKD and hypertensive patients.

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Title: Effects of fenoldopam on renal blood flow in hypertensive chronic kidney disease
Authors: Valentina Rovella
Michele Ferrannini
Manfredi Tesauro
Giulia Marrone
Andrea Busca
Roberto Sorge
Simone Manca di Villahermosa
Maurizio Casasco
Nicola Di Daniele
Annalisa Noce
Publication date: 01-02-2019
Publisher: Springer International Publishing
Published in: Journal of Nephrology / Issue 1/2019
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-018-0496-0

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