Managing the high-risk patient: experience with fenoldopam, a selective dopamine receptor agonist, in prevention of radiocontrast nephropathy during percutaneous coronary intervention.

Acute worsening of renal function due to contrast agents occurs in 15% to 40% of patients with baseline renal insufficiency undergoing percutaneous coronary intervention. Radiocontrast nephropathy is associated with increased morbidity, prolonged hospitalization, and higher in-hospital mortality. Our nonrandomized data suggest that in adequately hydrated patients, the dopamine-1 receptor agonist fenoldopam is a useful adjunct during PCI for prevention of RCN, reducing its incidence to less than 5%. This renoprotective effect of fenoldopam was more pronounced in diabetics, with moderate renal failure, in whom no agent has been shown so far to be beneficial.