title: Systemic effects of low-dose dopamine during administration of cytarabine.
abstract: Purpose Low-dose dopamine has been utilized to improve renal blood flow, urine output, and reduce drug-induced nephrotoxicity. The purpose of this study was to assess changes in renal function, cardiovascular adverse events, and neurologic toxicity in patients receiving cytarabine with or without low-dose dopamine. Methods A retrospective, single-center, cohort study of patients receiving cytarabine at 667 mg/m2/dose or greater, with or without dopamine at ≤5 mcg/kg/min. Cohorts were based upon initiation or absence of low-dose dopamine; cytarabine only, cytarabine + pre- and day of low-dose dopamine, and cytarabine + post-low-dose dopamine. Renal outcomes (urine output, serum creatinine, and creatinine clearance) were compared with baseline and between cohorts. Safety endpoints (arrhythmias, tachycardia, and neurotoxicity) were compared between cohorts based on low-dose dopamine exposure. Results There was no difference in urine output from baseline in all cohorts. Comparing cytarabine only and pre- and day of low-dose dopamine cohorts, there was no difference in urine output. In those receiving low-dose dopamine, there was no difference in serum creatinine and creatinine clearance from baseline. No arrhythmias were documented during the study period, and there was no difference in the incidence of tachycardia between groups (P = 0.66). Neurotoxicity was reported in three patients who were on low-dose dopamine. Conclusion Though variation existed in individual patients administered low-dose dopamine, the use of low-dose dopamine did not significantly impact renal function in this small sample at a single institution. In addition, low-dose dopamine did not negatively impact cardiovascular function.
authors.affiliation: 1 Department of Pharmacy Services, Providence Health and Services, USA.|2 Department of Pharmacy Services, The Johns Hopkins Hospital, USA.
authors.forename: James
authors.initials: J
authors.lastname: Connelly
authors.affiliation: 2 Department of Pharmacy Services, The Johns Hopkins Hospital, USA.
authors.forename: Dina J
authors.initials: DJ
authors.lastname: Benani
authors.affiliation: 2 Department of Pharmacy Services, The Johns Hopkins Hospital, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Newman
authors.affiliation: 2 Department of Pharmacy Services, The Johns Hopkins Hospital, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Burton
authors.affiliation: 2 Department of Pharmacy Services, The Johns Hopkins Hospital, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Crow
authors.affiliation: 3 Department of Oncology, The Johns Hopkins Hospital, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Levis
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003561:Cytarabine / Q000008:administration & dosage*; D004298:Dopamine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003561:Cytarabine; D004298:Dopamine
keywords: Dopamine; cytarabine; renal dysfunction; urine output