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

• Published in: Journal of nephrology 2019-02, Vol.32 (1), p.75-81
• Main Authors: Rovella, Valentina, Ferrannini, Michele, Tesauro, Manfredi, Marrone, Giulia, Busca, Andrea, Sorge, Roberto, Manca di Villahermosa, Simone, Casasco, Maurizio, Di Daniele, Nicola, Noce, Annalisa
• Format: Article
• Language: English
• Subjects: Aged; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - adverse effects; Arterial Pressure - drug effects; Blood Flow Velocity; Female; Fenoldopam - administration & dosage; Fenoldopam - adverse effects; Humans; Hypertension - complications; Hypertension - diagnostic imaging; Hypertension - drug therapy; Hypertension - physiopathology; Infusions, Intravenous; Italy; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Original Article; Renal Artery - diagnostic imaging; Renal Artery - drug effects; Renal Artery - physiopathology; Renal Circulation - drug effects; Renal Insufficiency, Chronic - diagnostic imaging; Renal Insufficiency, Chronic - drug therapy; Renal Insufficiency, Chronic - etiology; Renal Insufficiency, Chronic - physiopathology; Time Factors; Treatment Outcome; Ultrasonography, Doppler, Color; Urology; Vasodilator Agents - administration & dosage; Vasodilator Agents - adverse effects
• ISSN: 1121-8428; 1724-6059
• DOI: 10.1007/s40620-018-0496-0

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