Table 4.

Pharmacologic interventions for the prevention of kidney injury after CPB

TreatmentRCTnProtectionComments
Diuretics
    ref. 140Y126NoneFurosemide deleterious
    ref. 141N50NoneFurosemide deleterious
Dopamine
    ref. 127Y50NoneDopamine showed no benefit
    ref. 128Y40NoneDopamine showed no benefit
Fenoldopam
    ref. 131N108Yes50% decrease in ARF
    ref. 132Y80Yes0.39 mg/dl lower Scr post-op
    ref. 133N70YesCase-control series, lower ARF
Theophylline
    ref. 134Y56NoneScr and GFR unchanged
ANP
    ref. 138Y61YesLess dialysis required at day 21
Mannitol
    ref. 144Y40YesLower Scr in treated children
    ref. 145N56YesHigher urine output with mannitol
    ref. 146N15NoNo difference in urinary markersb
    ref. 147Y100NoNo difference in urinary markersb
Pentoxifylline
    ref. 150Y40YesNo change in GFR, less injury by urinary markersb
Dexamethasone
    ref. 152Y20NoNo change in GFR, urinary markersb
Clonidine
    ref. 156Y156YesHigher GFR in clonidine group
    ref. 157Y48YesHigher GFR in clonidine group
Diltiazem
    ref. 160Y24NoSimilar GFR to control
    ref. 161Y60YesImprovement in urinary markersb
    ref. 162N414NoIncreased ARF with diltiazem
    ref. 163Y330NoNo difference in GFR or ARF
  • aRCT, randomized, controlled trial; Scr, serum creatinine.

  • b Refers to the excretion of tubular proteins that can serve as a sensitive marker of tubular injury (164).