Dopamine administration in oliguria and oliguric renal failure

Parker, Stephen W.; Carlon, Graziano C.; Isaacs, Marian; Howland, William S.; Kahn, Roberta C.

doi:10.1097/00003246-198109000-00002

Cited by 116 publications

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“…D opamine (DA) is frequently administered at low infusion rates (1)(2) ,gg/kg/min) to selectively increase renal blood flow and increase sodium excretion. [1][2][3][4] These effects are due to the action of DA on DA, receptors.5 However, the dosage range of selectivity is limited and cannot be predicted for an individual patient.…”

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Cardiovascular and renal hemodynamic effects of intravenous infusions of the selective DA1 agonist, fenoldopam, used alone or in combination with dopamine and dobutamine.

1988

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Fenoldopam (0.1 and 0.2 p,g/kg/min i.v.) was administered to pentobarbital-anesthetized dogs alone and combined with dopamine (DA) and dobutamine. Renal blood flow, heart rate, and mean arterial pressure were measured. Both dosages of fenoldopam increased renal blood flow without altering blood pressure, similar to the effects of DA (1 and 2 ,ug/kg/min). Administration of fenoldopam with only DA (1 ,ug/kg/min) produced further increase in renal blood flow. June 9, 1988. administration is hypotension, which is due to DA1-receptor activation at lower dosages and possibly to a-adrenoceptor antagonist activity at extremely high dosages.10 1' One aim of the present study was to determine in the anesthetized dog the cardiovascular and renal hemodynamic effects of infusion rates of fenoldopam that do not affect or slightly reduce blood pressure. The second goal was to determine whether the effects of DA on cardiac contractile force, heart rate, blood pressure, and renal hemodynamics would be altered by fenoldopam. A third protocol was used to investigate the effects of fenoldopam on cardiovascular and renal responses of dobutamine at rates of 2 and 4 tg/kg/min. Dobutamine

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Cardiovascular and renal hemodynamic effects of intravenous infusions of the selective DA1 agonist, fenoldopam, used alone or in combination with dopamine and dobutamine.

1988

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“…Low-dose dopamine (0.5 to 3.0 jig/kg per min) has been shown to increase the glomerular filtration rate and increase urine output (8, 10). Acute oliguric renal failure occurs commonly during gram-negative sepsis, and low-dose dopamine has been used in this setting in an attempt to convert oliguric renal failure to nonoliguric renal failure (8,10,12).This study was designed to test the hypothesis that lowdose dopamine will increase the CL of tobramycin. We elected to perform a study in animals to assess whether further human investigation is necessary, since the pharmacokinetics of the aminoglycosides and the pharmacology of dopamine are similar in humans and canines (1,8,15).…”

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“…In addition, renal plasma flow is enhanced by 100%. Urine output can increase by 100%, and increases in urinary sodium excretion have been seen in both human and animal studies (8,9,12). These pharmacologic properties could affect the CLR of many drugs.…”

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“…This depends primarily upon the degree of ionization and lipid solubility of the drug in the tubule and on a concentration gradient for movement of drug from the lumen of the tubule into blood. Increasing urine flow reduces this concentration gradient, allowing more drug to be excreted (5,12). In the anesthetized dog, dopamine (6 to 15 p.g/kg per min) increased the CLR of salicylate (a drug reabsorbed and secreted) and phenobarbital (a drug reabsorbed) by 72 and 134%, respectively (7).…”

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Effect of low-dose dopamine on the pharmacokinetics of tobramycin in dogs

Kirby¹,

Dasta²,

Armstrong³

et al. 1986

Antimicrob Agents Chemother

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Low-dose dopamine or a placebo was given to six healthy mongrel dogs, each receiving tobramycin at 2.0 mg/kg on consecutive days in a randomized crossover fashion. Dopamine increased the total and renal clearances and elimination rate constant of tobramycin by 12.5, 20, and 25.9%, respectively, suggesting that low-dose dopamine increases the clearance of tobramycin in dogs primarily through renal mechanisms.Drug interactions commonly occur in clinical medicine. The significance of these interactions is magnified when they affect the pharmacokinetics of drugs with a narrow therapeutic index. These interactions have the potential either to change the therapeutic response to a drug or to increase the risk of toxicity. It is therefore important to identify these interactions before they occur, to avoid any unexpected response.Tobramycin, an aminoglycoside with a narrow therapeutic index, is commonly used to treat infections with gramnegative bacteria. This drug is primarily excreted by the kidney. Tobramycin is mostly filtered at the glomerulus, with some tubular reabsorption. Changes in glomerular filtration rate and urine flow are likely to affect the clearance (CL) of this drug (1, 3-5, 13, 15). Low-dose dopamine (0.5 to 3.0 jig/kg per min) has been shown to increase the glomerular filtration rate and increase urine output (8, 10). Acute oliguric renal failure occurs commonly during gram-negative sepsis, and low-dose dopamine has been used in this setting in an attempt to convert oliguric renal failure to nonoliguric renal failure (8,10,12).This study was designed to test the hypothesis that lowdose dopamine will increase the CL of tobramycin. We elected to perform a study in animals to assess whether further human investigation is necessary, since the pharmacokinetics of the aminoglycosides and the pharmacology of dopamine are similar in humans and canines (1,8,15).(This research was presented at the 6th Annual Meeting of the American College of Clinical Pharmacy, Orlando, Fla., 1985.) Six male mongrel dogs (18 to 20 kg) were studied. Before the day of the experiment, all dogs had normal complete blood count, leukocyte differential, serum electrolyte, serum creatinine, and blood urea nitrogen results. Each animal was fasted for 12 hours before each study day and placed standing in a sling. The external jugular and brachiocephalic veins were cannulated for blood withdrawal and for fluid and drug administration, respectively.Each animal received 150 to 200 ml of normal saline per h during the study. A urethral catheter was inserted for urine collection, and the bladder was emptied before tobramycin was administered. Each dog received tobramycin plus a placebo (5% glucose in water) and tobramycin plus dopamine in a randomized crossover fashion on two consecutive days. Tobramycin at 2.0 mg/kg was given intravenously over * Corresponding author. 30 s. Thirty minutes before the tobramycin dose on the dopamine treatment days, an intravenous infusion of dopamine was started at a dose of 2.5 ,ug/kg per min by an infus...

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Hemodynamic Management

Mahajan¹,

Marijic²

2005

Anesthesia for Congenital Heart Disease

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Dopamine administration in oliguria and oliguric renal failure

Cited by 116 publications

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Cardiovascular and renal hemodynamic effects of intravenous infusions of the selective DA1 agonist, fenoldopam, used alone or in combination with dopamine and dobutamine.

Cardiovascular and renal hemodynamic effects of intravenous infusions of the selective DA1 agonist, fenoldopam, used alone or in combination with dopamine and dobutamine.

Effect of low-dose dopamine on the pharmacokinetics of tobramycin in dogs

Hemodynamic Management

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