Effect of "renal-dose" dopamine on renal function following cardiac surgery.
The efficacy of renal-dose dopamine to improve renal function or reduce renal impairment was studied in 52 patients undergoing elective coronary artery bypass surgery. The patients were prospectively randomised in a double-blind fashion to receive dopamine at 200 micrograms/min (group D) or placebo (group P) from induction for 24 hours. Although dopamine improved haemodynamics, there was no effect on urine output at 4 hours (D = 917, P = 1231 ml: P = 0.066); urine output at 24 hours (D = 3659, P = 3304 ml: P = 0.36); creatinine clearance at 0-4 hours (D = 104, P = 127 ml/min: P = 0.27); creatinine clearance on admission to ICU-4 hours (D = 94.8, P = 83.4 ml/min: P = 0.48); creatinine clearance at 20-24 hours (D = 91.2, P = 107 ml/min: P = 0.48); free-water clearance at 0-4 hours (D = 29.6, P = -59.8 ml/hr: P = 0.069); free-water clearance at 20-24 hours (D = 43.2, P = -48.9 ml/hr: P = 0.55). The incidence of transient renal impairment was similar in both groups (D = 36%, P = 50%: P = 0.65). Our study failed to demonstrate that routine prophylactic renal-dose dopamine is associated with improvement in renal function, or with prevention of transient renal impairment in patients undergoing coronary artery bypass surgery.
Myles
P S
PS
Dept of Anaesthesia, Alfred Hospital, Prahran, Victoria, Australia.
Buckland
M R
MR
Schenk
N J
NJ
Cannon
G B
GB
Langley
M
M
Davis
B B
BB
Weeks
A M
AM
D058186:Acute Kidney Injury / Q000517:prevention & control; D001834:Body Water / Q000737:chemistry; D002302:Cardiac Output / Q000187:drug effects; D001026:Coronary Artery Bypass; D003404:Creatinine / Q000097:blood / Q000652:urine; D004232:Diuretics / Q000627:therapeutic use; D004298:Dopamine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007668:Kidney / Q000187:drug effects* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D013997:Time Factors; D014556:Urine
D004232:Diuretics; D010919:Placebos; D003404:Creatinine; D004298:Dopamine