Effect of Dopamine on Renal Function during Aortic Cross-Clamping

Abstract

haemodynamics (1-3). Occlusion of the aorta below the renal arteries gives rise to a 75% increase in the renal vascular resistance and 38% decrease in the renal blood flow (1). Mean arterial plasma renin activity was found to rise during anaesthesia for surgery of the abdominal aorta and to rise further after removal of the cross clamp (4). Dopamine infusion in normal subjects, at a rate of 2 to 10 ,tg/kg body wt/min increases the renal blood flow, and increases the glomerular filtration rate and excretion of sodium (5). In anaesthetised patients also, dopamine infusion increased the renal blood flow (6). A study was therefore undertaken to investigate the effect of dopamine upon renal function and plasma renin activity during the period of cross clamping.

Kidney dysfunction in the postoperative period

“…74 However, Salem and colleagues demonstrated a positive advantage of low-dose dopamine (2 mg kg À1 min À1 ) when given in combination with fluid loading using Hartmann's solution (15 ml kg À1 h À1 ) again during aortic cross-clamping. 83 There were postoperative increases in urine volume, creatinine clearance, and sodium and potassium output.…”

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease

“…Pharmacological agents, including mannitol (760,761), furosemide (758), or dopamine (757,(761)(762)(763)(764), have not been demonstrated to provide renal protection during descending thoracic aortic repair.…”

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease

“…626 Selective renal artery perfusion during descending thoracic aortic repair may result in uninterrupted urine production throughout the procedure and may decrease the incidence of renal failure postoperatively. 755 Pharmacological agents, including mannitol, 760,761 furosemide, 758 or dopamine, 757,[761][762][763][764] have not been demonstrated to provide renal protection during descending thoracic aortic repair.…”