The effect of low-dose dopamine on renal function in uninephrectomized patients: special emphasis on kidney donors before and after nephrectomy.
In rats, uninephrectomy and subtotal renal ablation result in the development of hypertension and proteinuria, and, in a progressively downhill course of renal function, to end-stage renal disease. These events are attributed to glomerular hyperfiltration of remnant glomeruli. In man, however, long-term effects of unilateral nephrectomy appear to be less disastrous. The infusion of a low dose of dopamine (1.5-2.0 micrograms/kg/min) can be used to test the presence of a reserve filtration capacity i.e., the absence or existence of glomerular hyperfiltration. In order to investigate whether in man glomerular hyperfiltration occurs after unilateral nephrectomy, the effects of low-dose dopamine on glomerular filtration rate (clearance of 125I-iothalamate) and effective renal plasma flow (clearance of 131I-hippurate) of 18 uninephrectomized patients were investigated and compared with the effects of low-dose dopamine on those parameters of 32 healthy volunteers. Special interest was given to a subgroup of 10 kidney donors who were investigated before and after nephrectomy. Median values for the percentage of a dopamine-induced rise in the glomerular filtration rate were 4.5% in the uninephrectomized subjects and 10.0% in the control subjects (p less than 0.01). Median dopamine-induced increase in effective renal plasma flow as 22.5% and 35.0%, respectively (p less than 0.01). In the kidney donors the median percentage of a dopamine-induced change in the glomerular filtration rate was 12.4% before and 5.9% after nephrectomy (p less than 0.05%). It is concluded firstly, that renal reserve filtration capacity is decreased after unilateral nephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Internal Medicine, State University Hospital, Groningen, The Netherlands.
P M
PM
ter Wee
A M
AM
Tegzess
A J
AJ
Donker
D000328:Adult; D004298:Dopamine / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007263:Infusions, Parenteral; D007668:Kidney / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012079:Renal Circulation / Q000187:drug effects; D014019:Tissue Donors
D004298:Dopamine