title: Evolution of Hemodynamic and Functional Human Kidney Graft Dose Response to Dopamine Using an Implantable Doppler Device.
abstract: OBJECTIVE
  The relation between dopamine infusion and renal hemodynamics and function has not been studied in renal allografts during early recovery. We analyzed the dose response of dopamine infusion on renal blood flow and function in human kidney transplant recipients at reperfusion and during early graft recovery.
  
  
  METHODS
  Phasic and mean renal blood flow was measured by the pulsed Doppler technique using implantable Doppler microprobes in contact with the graft artery. Systemic and renal parameters were recorded on dopamine infusion (0, 3, 5, and 10 μg·kg⁻¹·min⁻¹) immediately after transplant (day 0) in 13 patients and at day 6 in 7/13 patients with early graft recovery. Results are expressed as median and interquartile range between the 25th and 75th percentiles.
  
  
  RESULTS
  
  
  
  RESULTS
  At day 0, 3 μg·kg⁻¹·min⁻¹) dopamine did not increase mean renal blood flow over baseline (580 mL/min [219-663 mL/min] vs 542 mL/min [207-686 mL/min]; P = .84). There was an absence of effect with higher dopamine doses, whereas cardiac output, heart rate, and systolic and mean arterial pressure were significantly increased. Urinary sodium excretion, creatinine clearance, and urine output increased dose dependently, with a positive correlation between the increase in urine output and mean arterial pressure (r = 0.48, P < .001). At day 6, 3 μg·kg⁻¹·min⁻¹ dopamine increased mean renal blood flow over baseline (318 mL/min [234-897 mL/min] vs 191 mL/min [173-706 mL/min]; P = .016), with no further increase at higher doses.
  
  
  CONCLUSIONS
  Immediately after transplant, kidney grafts with ischemic-reperfusion injury are fully dilated and do not respond to dopamine. The specific renal effects observed are due to systemic hemodynamic status. Vascular responsiveness to a "renal dopamine dose" returns on graft recovery.
authors.affiliation: From the Department of Anesthesia and Intensive Care, Groupe Hospitalier Universitaire Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris, 75010, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Bataille
authors.forename: Didier
authors.initials: D
authors.lastname: Payen
authors.forename: Stéphane
authors.initials: S
authors.lastname: Villiers
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Chazalet
authors.forename: Laurent
authors.initials: L
authors.lastname: Jacob
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004298:Dopamine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007263:Infusions, Parenteral; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012077:Renal Artery / Q000187:drug effects* / Q000503:physiopathology / Q000601:surgery*; D012079:Renal Circulation / Q000187:drug effects*; D015427:Reperfusion Injury / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D013566:Sympathomimetics / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D018617:Ultrasonography, Doppler, Pulsed / Q000295:instrumentation*; D055815:Young Adult
chemical_list: D013566:Sympathomimetics; D004298:Dopamine