Renal and humoral effects of ibopamine, a dopamine agonist, in patients with liver cirrhosis.
We investigated the renal and humoral effects of short-term administration of ibopamine, an orally active dopamine agonist, in patients with liver cirrhosis. The patients were divided into two groups on the basis of sodium excretion with a constant sodium intake of 40 mEq/d. We also compared the effects of ibopamine with those induced by intravenous infusion of dopamine hydrochloride (3 micrograms/kg per minute) in similar patients. Ibopamine caused significant increases in urine output, glomerular filtration rate, and sodium excretion throughout the 4 hours of the trial in patients with basal sodium excretion rate greater than 20 mmol/d. These renal effects were associated with a significant reduction in plasma aldosterone concentration. In contrast, only a transient increase in glomerular filtration rate and a diminution in plasma aldosterone concentration were observed after ibopamine in the patients with a basal sodium excretion rate less than 20 mmol/d. The infusion of dopamine had renal effects similar to those of ibopamine in both groups of patients. These results indicate that in cirrhotic patients with normal sodium excretion, ibopamine exerts a diuretic and natriuretic effect similar to that of dopamine infusion. However, these properties of dopaminergic agents are apparently lost in patients with avid sodium retention.
Salerno
F
F
Institute of Internal Medicine, University of Milan Medical School, Italy.
Incerti
P
P
Badalamenti
S
S
Lorenzano
E
E
Graziani
G
G
Morganti
A
A
Ghirardi
P
P
D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D003846:Deoxyepinephrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004298:Dopamine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects; D012083:Renin / Q000097:blood
D004232:Diuretics; D015259:Dopamine Agents; D000450:Aldosterone; C023487:ibopamine; D012083:Renin; D003846:Deoxyepinephrine; D004298:Dopamine