SynthesisCritical care (London, England)2015
Fenoldopam to prevent acute kidney injury after major surgery-a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Fenoldopam for preventing and treating acute kidney injury.The Cochrane database of systematic reviews · 2024Pooled it
- Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017 : Expert opinion of the Working Group on Prevention, AKI section, European Society of Intensive Care Medicine.Intensive care medicine · 2017Pooled it
- Perioperative glycemic control in patients undergoing cardiac surgery.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2025Review
- Fenoldopam for Renal Protection in Cardiac Surgery: Pharmacology, Clinical Applications, and Evolving Perspectives.Journal of clinical medicine · 2024Review
- Drugs in treating paediatric acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2023Review
- Perioperative Acute Kidney Injury: Implications, Approach, Prevention.Advances in anesthesia · 2023Review
- Review
- Antibiotic Therapy in the Critically Ill with Acute Renal Failure and Renal Replacement Therapy: A Narrative Review.Antibiotics (Basel, Switzerland) · 2022Review
- Use of Fenoldopam in Children with Congenital Heart Disease to Decrease Fluid Balance: A Retrospective, Descriptive Study and Insights into Predictors of Decreased Fluid Balance.Journal of pediatric intensive care · 2022Article
- Insights into cisplatin-induced neurotoxicity and mitochondrial dysfunction in Caenorhabditis elegans.Disease models & mechanisms · 2022Article
- N6-methyladenosine regulators-related immune genes enable predict graft loss and discriminate T-cell mediate rejection in kidney transplantation biopsies for cause.Frontiers in immunology · 2022Article
- Future insights of pharmacological prevention for AKI post cardiopulmonary bypass surgery (based on PK/PD approach).Frontiers in pharmacology · 2022Review
- Article
- Cardiac Surgery Associated AKI Prevention Strategies and Medical Treatment for CSA-AKI.Journal of clinical medicine · 2021Article
- Perioperative Renoprotection: General Mechanisms and Treatment Approaches.Anesthesia and analgesia · 2020Review
- Article
- Acute Kidney Injury Associated with Cardiac Surgery: a Comprehensive Literature Review.Brazilian journal of cardiovascular surgery · 2020Review
- Monoaminergic Receptors as Modulators of the Perivascular Sympathetic and Sensory CGRPergic Outflows.Current neuropharmacology · 2020Review
- Prevention of Cardiac Surgery-Associated Acute Kidney Injury: A Review of Current Strategies.Anesthesiology clinics · 2019Review
- Effects of fenoldopam on renal blood flow in hypertensive chronic kidney disease.Journal of nephrology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury (AKI) after surgery is associated with increased mortality and healthcare costs. Fenoldopam is a selective dopamine-1 receptor agonist with renoprotective properties. We conducted a systematic review and meta-analysis of randomised controlled trials comparing fenoldopam with placebo to prevent AKI after major surgery.
methodsWe searched EMBASE, PubMed, meta-Register of randomised controlled trials and Cochrane CENTRAL databases for trials comparing fenoldopam with placebo in patients undergoing major surgery. The primary outcome was incidence of new AKI. Secondary outcomes were requirement for renal replacement therapy and hospital mortality.
resultsEighty-three publications were screened; 23 studies underwent full data extraction and scoring. Six trials were suitable for inclusion in the data synthesis (total of 507 subjects undergoing cardiovascular surgery, partial nephrectomy, liver transplant surgery). Five studies were rated at high risk of bias. Data on post-operative incidence of AKI were available in five of the six trials (total of 471 patients) but definitions of AKI varied between studies. Of the 238 patients receiving fenoldopam, 45 (18.9%) developed AKI compared to 62 (26.6%) of the 233 patients who received placebo (p = 0.004, I (2) = 0 %; random-effects model odds ratio 0.46, 95% confidence interval 0.27-0.79). In patients treated with fenoldopam, there was no difference in renal replacement therapy (n = 478; p = 0.11, I (2) = 47%; fixed-effect model odds ratio 0.27, 95% confidence interval 0.06-1.19) or hospital mortality (p = 0.60, I (2) = 0 %; fixed-effect model odds ratio 1.0, 95% confidence interval 0.14-7.37).
conclusionsIn this analysis, peri-operative treatment with fenoldopam was associated with a significant reduction in post-operative AKI but it had no impact on renal replacement therapy or hospital mortality. Equipoise remains for further large trials in this area since the studies were conducted in three types of surgery, the majority of studies were rated at high risk of bias and the criteria for AKI varied between trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.