Low-dose dopamine during cardiopulmonary bypass in patients with renal dysfunction.
Thirty-six patients with preoperative renal dysfunction were studied to evaluate the effects of dopamine (D) and dopamine-nitroprusside (DN) on renal function during cardiopulmonary bypass (CPB). No differences from the control group (C) were found in creatinine clearance, fractional sodium excretion, osmolarity and free-water clearance. Sodium output/intake ratio during CPB was higher in group D than in groups C and DN (P less than 0.05); water output/intake ratio was higher in group D than in group C (P less than 0.05). Urine lysozime levels and alpha-glycosidase/creatinine ratios increased similarly in the three groups, suggesting ischemic tubular cell damage. No patients showed acute postoperative renal failure or a worsening of their renal dysfunction. The data suggest an increased water and sodium excretion during CPB with a dopamine infusion, possibly resulting from a renal vasodilator effect that was abolished by simultaneous nitroprusside administration.
Costa
P
P
Department of Cardiac Surgery, University of Torino, Italy.
Ottino
G M
GM
Matani
A
A
Pansini
S
S
Canavese
C
C
Passerini
G
G
Grezzana
G
G
D000368:Aged; D001834:Body Water; D002315:Cardiopulmonary Bypass; D003404:Creatinine / Q000097:blood / Q000652:urine; D004231:Diuresis / Q000187:drug effects; D004298:Dopamine / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006026:Glycoside Hydrolases / Q000652:urine; D006331:Heart Diseases / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007262:Infusions, Intravenous; D007674:Kidney Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007684:Kidney Tubules / Q000187:drug effects; D008875:Middle Aged; D009113:Muramidase / Q000652:urine; D009599:Nitroprusside / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D009994:Osmolar Concentration; D011446:Prospective Studies; D012964:Sodium / Q000097:blood / Q000652:urine
D009599:Nitroprusside; D012964:Sodium; D003404:Creatinine; D006026:Glycoside Hydrolases; D009113:Muramidase; D004298:Dopamine