title: A meta-analysis of low-dose dopamine in heart failure.
abstract: BACKGROUND
  Heart failure (HF) is a major health problem worldwide with no proven therapy. Low-dose dopamine (LDD) has been applied to patients with HF to enhance diuresis and preserve renal function since the last century. However, the efficacy of LDD in HF has been questioned by several studies recently. The purpose of this meta-analysis is to appraise the effects of the LDD to HF.
  
  
  METHODS
  Relative trials were identified in the PubMed, The Web of Science, OVID EBM Reviews and Cochrane databases, and the relevant papers were examined. Pooled mean difference (MD) and 95% confidence interval (95% CI) were estimated by random effects models. The primary endpoints in our meta-analysis were renal function, determined by blood urea, creatinine levels, eGFR and urine output. Secondary endpoints were rates of all-cause mortality and readmission after treatment.
  
  
  RESULTS
  Six randomized controlled trials (RCTs) and one retrospective study involving 587 patients were included in this analysis. LDD enhanced eGFR (MD, 7.44; 95% CI, 1.92-12.95; P=0.008), urine output (SMD, 0.58; 95% CI, 0.15-1.01; P=0.008) and decrease creatinine levels (MD, -0.36; 95% CI, -0.64/-0.08; P=0.004), blood urea (MD, -6.97; 95% CI, -13.12/-0.81; P=0.03). No statistically significant differences in the rates of mortality (RR, 0.86; 95% CI, 0.62-1.20, P=0.37) and readmission (RR: 0.86; 95% CI 0.47-1.56, P=0.62) were noted.
  
  
  CONCLUSIONS
  LDD indeed brought benefits in terms of promoting diuresis and preserving renal function for HF patients. It did not demonstrate statistical significance in rates of readmission nor mortality. The efficacy of LDD to HF patients should be confirmed by further large, high quality clinical trials.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
authors.forename: Fuwei
authors.initials: F
authors.lastname: Xing
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
authors.forename: Jingzhou
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China. Electronic address: xingfuwei1992@sina.com.
authors.forename: Yuedong
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China. Electronic address: 15626428670@163.com.
authors.forename: Anli
authors.initials: A
authors.lastname: Tang
mesh_terms: D004298:Dopamine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012189:Retrospective Studies
chemical_list: D004298:Dopamine
keywords: Clinical trials; Dopamine; Heart failure; Low-dose; Meta-analysis; Renal function