Low-dose dopamine in kidney transplantation.
BACKGROUND
The use of low-dose dopamine (LDD; 0.5-2.5 mug/kg/min) in kidney transplant recipients seeks to increase urine output, prevent arterial vasospasm, and reduce the incidence of acute tubular necrosis. The aim of this study was to evaluate the effect of LDD in the early postoperative period (12 hours) among kidney transplant recipients.


METHODS
We studied all kidney transplant recipients admitted to the Intensive Care Unit (ICU) in the early postoperative period from January 2004 to December 2008. A total of 105 patients were retrospectively assigned to two groups: group A (n = 57) was treated with LDD and group B (n = 48), not treated with LDD. All patients otherwise received the same therapy. Blood sample analysis and kidney function were recorded at 0, 6, and 12 hours after admission. For each patient, we collected the following data: donor and transplant kidney features, recipient demographics, intraoperative events, hemodynamic and kidney function parameters in the ICU, and outcomes. Patients were followed for 6 months after ICU discharge.


RESULTS
Hourly diuresis and kidney function parameters showed no significant difference between the groups. Significant differences between group A and group B were observed in heart rate (92.63 +/- 14.18 vs 82.87 +/- 13.5, respectively), hours of ICU length of stay (29.0 +/- 17.42 vs 20.43 +/- 7.35, respectively), and 6-month mortality rate (8.8% vs 0%, respectively; P < .05).


CONCLUSIONS
LDD prescription in kidney transplantation neither improved kidney function during the postoperative period nor short-term outcomes, but was associated with an increased heart rate, ICU length of stay and 6-month mortality.
Ciapetti
M
M
Intensive Care and Anesthesia Unit of the Emergency Department, Careggi Teaching Hospital, Florence, Italy.
di Valvasone
S
S
di Filippo
A
A
Cecchi
A
A
Bonizzoli
M
M
Peris
A
A
D000328:Adult; D000368:Aged; D001806:Blood Urea Nitrogen; D004231:Diuresis / Q000187:drug effects / Q000502:physiology; D004298:Dopamine / Q000008:administration & dosage / Q000627:therapeutic use*; D015259:Dopamine Agents / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D016030:Kidney Transplantation / Q000502:physiology*; D007773:Lactates / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D015259:Dopamine Agents; D007773:Lactates; D004298:Dopamine