Contrast-induced nephropathy: Protective role of fenoldopam

Contrast-induced nephropathy (CIN) often occurs after contrast media-related procedures and is associated with increased morbidity and mortality. The acute renal failure observed after administration of contrast media is usually transient but, in some cases, it can be severe enough to lead to permanent renal damage with life-long dialysis. Except for saline hydration, no other treatment has been shown to have a consistent benefit in protecting against CIN. Despite sound physiological and pharmacological bases, intravenous infusion of fenoldopam does not prevent CIN. Initial studies have shown the safety of and favourable results with direct infusion of fenoldopam into the renal arteries using the Benephit renal infusion system (FlowMedica-AngioDynamics, Latham, NY, USA). These results are encouraging and suggest that intrarenal delivery of fenoldopam has an advantage in patients with a high risk of developing CIN. A randomized controlled study comparing intrarenal fenoldopam with placebo is warranted.