Table 3.

Randomized controlled trials with fenoldopam, sodium bicarbonate, and haemodialysis/haemofiltration as prophylactic measures to prevent contrast-induced nephropathy

Reference	Year	Number of patients	Reason for contrast administration	Study design	Dose/timing/route of drug administration	Hydration regimen	Main outcomea
Clinical trials with fenoldopam
[23]	2002	123	Cardiovascular procedures	RCT: hydration plus NAC po versus hydration alone versus hydration plus fenoldopam	Fenoldopam: 0.1 μg/kg per min, 4 hours before – 4 hours after contrast NAC 2 × 600 mg	1 ml/kg per hour 0.45% NaCl iv 12 hours before – 12 hours after contrast	18% in the NAC group versus 15% in the NaCl group (P = NS; RR 1.18, 95% CI 0.45–3.12)
[48]	2002	45	Cardiovascular procedures	RCT: hydration versus hydration plus fenoldopam	Fenoldopam at 0.1 μg/kg per min, >1 hour before contrast	100 ml/hour 0.45% NaCl iv, 3 hours before – 4 hours after contrast	41% in the saline group versus 21% in the fenoldopam group(P = 0.148); diabetes patients 64% versus 33% (P = 0.14)
[49]	2003	315	Angiography	RCT: fenoldopam	Fenoldopam 0.05 μg/kg per min titrated to 0.10 μg/kg per min, 30 min before – 12 hours after contrast	1.5 ml/kg per hour 0.45% NaCl iv 2–12 hours before – 12 hours after contrast	34% in fenoldopam group versus 30% in the placebo group (P = 0.61; RR 1.11, 95% CI 0.79–1.57)
Clinical trials with sodium bicarbonate
[37]	2004	119	Various reasons	RCT: saline versus sodium bicarbonate before and after contrast administration	3 ml/kg per hour 154 mEq/l sodium bicarbonate 1 hour pre-procedure + 1 ml/kg per hour154 mEq/l sodium bicarbonate 6 hours post-procedure	The control group received a similar infusion, but with 154 mEq/l NaCl	14% in saline patients versus 2% in patients receiving sodium bicarbonate (P = 0.02; 95% CI 0.03–0.21)
Clinical trials with haemodialysis/haemofiltration
[50]	2001	113	Various reasons	RCT: haemodialysis versus nonhaemodialysis treatment after injection of contrast	Directly after contrast exposure	1 ml/kg per hour 0.45% NaCl iv 12 hours before – 12 hours after contrast	No significant differences
[52]	2003	114	Coronary angioplasty	RCT: haemofiltration (in an intensive care unit) versus hydration (in a step-down unit)	4–8 hours before to 18–24 hours after procedure	1 ml/kg per hour 0.45% NaCl iv 12 hours before – 12 hours after contrast	5% versus 50% (P < 0.001)
[53]	2003	17	Angiography	RCT: 4-hour online dialysis during contrast injection versus standard therapy	Haemodialysis simultaneously with contrast administration	2000 ml 0.9% NaCl 6 hours before – 6 hours after contrast	No significant differences

^aIncidences of contrast-induced nephropathy. CI, confidence interval; iv, intravenously; NAC, N-acetylcysteine; po, by mouth; RCT, randomized controlled trial; RR, relative risk.