Winstgevend schreef op 26 oktober 2018 09:36:
Sandoz: Corlopam (fenoldopam) results against CIN proved ineffective.
Of note, creatinine levels typically peak 3-5 days after administration of contrast,
thus the number of patients with CIN may be much larger than estimates predict.
Risk factors for developing CIN include pre-existing renal dysfunction,
diabetes mellitus, increasing age, heart failure, hypertension, low effective
circulatory volume, myocardial infarction, and use of an intraaortic balloon pump.
Currently, the only widely accepted prophylaxis is hydration of the patient
using normal saline before contrast is administered.
This presents limitations, however,
as not all patients are able to handle large volumes of fluid.
Because of this, research has been ongoing to determine what, if anything,
can be done to limit the incidence of CIN and to further assess the role
of hydration in prevention of CIN.
Multiple agents and combinations of agents have been studied for the prevention of CIN.
Stone and colleagues evaluated fenoldopam for the prevention of CIN in patients
with elevated serum creatinine at baseline.
They found that the study dose of fenoldopam was ineffective in reducing rates of CIN.
Additionally, they determined that no dose or infusion rate of fenoldopam
would have been effective.