Regadenoson use in chronic kidney disease and end-stage renal disease: A focused review.

Abstract

Regadenoson is a selective A2A adenosine receptor agonist that has been approved as a vasodilator stress agent with single-photon emission-computed tomography (SPECT) myocardial perfusion imaging (MPI). Since its approval by the Food and Drug Administration (FDA) in 2008, it has become the most commonly used pharmacologic stress agent with SPECT-MPI. Given that it is predominantly renally excreted, its use in patients with chronic kidney disease has been the subject of active post-marketing clinical research. Until recently, prescribing information regarding the use of regadenoson in patients with end-stage renal disease (ESRD) was not defined in the package insert. Based on accumulating data since its initial approval, the FDA has recently outlined the use of regadenoson in patients with ESRD in a label update on January 17, 2017. In this review, we discuss the evidence leading to the recent label update, focusing on the pharmacokinetics of regadenoson in patients with impaired kidney function, the safety and tolerability of regadenoson in patients with chronic kidney disease and ESRD, and the prognostic value of regadenoson stress MPI in this patient population.

• Authors: Aviral Vij, Yasmeen Golzar, Rami Doukky
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 25 Issue 1 Pg. 137-149 (02 2018) ISSN: 1532-6551 [Electronic] United States
• PMID: 28653271 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Adenosine A2 Receptor Agonists
• Purines
• Pyrazoles
• Aminophylline
• regadenoson

Topics

• Adenosine A2 Receptor Agonists (adverse effects, pharmacokinetics)
• Aminophylline (therapeutic use)
• Comorbidity
• Exercise Test
• Humans
• Kidney Failure, Chronic (physiopathology)
• Kidney Function Tests
• Myocardial Perfusion Imaging
• Observational Studies as Topic
• Patient Safety
• Prognosis
• Purines (adverse effects, pharmacokinetics)
• Pyrazoles (adverse effects, pharmacokinetics)
• Randomized Controlled Trials as Topic
• Renal Dialysis
• Risk
• Tomography, Emission-Computed, Single-Photon