Fenoldopam and GFR

 Q: Fenoldopam ____________  glomerular filtration rate (GFR)? (select one)

A) increases

B) decreases

Answer: A

Fenoldopam is an anti-hypertensive and a peripheral dopamine-1 receptor agonist. It has an unique advantage of not compromising and many times to increase the renal perfusion. It is a good intravenous infusion of choice to control blood pressure in patients with renal insufficiency. It also increases the urine output. Sodium should be watched carefully as it may increase renal excretion of sodium. Patients can be sensitive in response and should be started at lowest dose at 0.1 mcg/kg per minute, and can be titrated every 15 minutes to the maximum dose of 2.0 mcg/kg per minute.

#hemodynamic

#nephrology

#pharmacology

References:

1. Murphy MB, Murray C, Shorten GD. Fenoldopam: a selective peripheral dopamine-receptor agonist for the treatment of severe hypertension. N Engl J Med 2001; 345:1548. 

2. White WB, Halley SE. Comparative renal effects of intravenous administration of fenoldopam mesylate and sodium nitroprusside in patients with severe hypertension. Arch Intern Med 1989; 149:870. 

3Shusterman NH, Elliott WJ, White WB. Fenoldopam, but not nitroprusside, improves renal function in severely hypertensive patients with impaired renal function. Am J Med 1993; 95:161.