Renal effects of low-dose dopamine in patients with sepsis syndrome or septic shock treated with catecholamines.
OBJECTIVE
To evaluate the renal effects of low-dose dopamine in patients with sepsis syndrome or septic shock treated with catecholamines.


METHODS
Prospective, clinical study using sequential periods.


METHODS
A 12-bed surgical intensive care unit in a university hospital.


METHODS
14 patients with sepsis syndrome and 15 patients with septic shock treated with exogenous catecholamines were studied. They had no diuretic treatment.


METHODS
Two periods of 2 h each with and without 2 micrograms.kg-1.min-1 of dopamine infusion. Hemodynamic and renal data were obtained at the end of each period. Measurements were repeated after 48 h of dopamine infusion in patients with sepsis syndrome. All data were evaluated by the Wilcoxon rank test.


RESULTS
In patients with sepsis syndrome, diuresis and creatinine clearance increased significantly by 100% and 60%, respectively, during low-dose dopamine infusion without any change in systemic hemodynamics. The renal response to dopamine decreased significantly after 48 h of dopamine infusion (P < 0.01). In patients with septic shock treated with catecholamines, no variation of either systemic hemodynamics or renal function was noted during low-dose dopamine infusion.


CONCLUSIONS
The renal effects of low-dose dopamine in patients with sepsis syndrome decrease with time. No renal effect of low-dose dopamine was observed in patients with septic shock treated with catecholamines. These findings suggest a desensitization of renal dopaminergic receptors.
Lherm
T
T
Departement d'Anesthésie-Réanimation, Hôpital Antoine Béclère, Université Paris-Sud, Clamart, France.
Troché
G
G
Rossignol
M
M
Bordes
P
P
Zazzo
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004298:Dopamine / Q000008:administration & dosage / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects*; D008875:Middle Aged; D011446:Prospective Studies; D012772:Shock, Septic / Q000188:drug therapy* / Q000503:physiopathology; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors
D004298:Dopamine