Effect of Intravenous Infusion of Low-Dose Dopamine on Renal Function in Normal Individuals and in Patients with Renal Disease

Wee, Pieter M. ter; Smit, A. J.; Rosman, Johan B.; Sluiter, Willem; Donker, A. J. M.

doi:10.1159/000167051

Cited by 79 publications

(21 citation statements)

References 5 publications

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“…Swärd et al evaluated the renal eff ects of a bolus dose of furosemide (0.5 mg/kg) followed by an infusion (0.5 mg/ kg/h) in the early p eriod after cardiac surgery with cardiopulmonary bypass (CPB), using the retrograde renal vein thermodilution technique and renal extraction of 51 chromium-ethylene-diaminetetraacetic acid ( 51 Cr-EDTA) for rapid bedside estimation of RBF and GFR without the need for urine collection [5] (Fig. 2).…”

Section: Eff Ects Of Diureti Cs On Renal Oxygenation In the Postoperamentioning

confidence: 99%

“…Nor epineph rine infusion rate was randomly and sequentially titrated to target a mean arterial pressures (MAP) of 60, 75 and 90 mm Hg. At each target MAP, data on renal blood fl ow, GFR and renal O 2 Ex were obtained by the renal vein thermodilution technique and by renal extraction of 51 Cr-EDTA. At a target MAP of 75 mm Hg, renal DO 2 (13 %), GFR (27 %) and urine fl ow were higher and renal O 2 Ex was lower (-7.4 %) compared with a target MAP of 60 mm Hg.…”

Section: Vasodilatory Shock and Aki: Role Of Norepinephrinementioning

confidence: 99%

See 1 more Smart Citation

Renal Oxygenation in Clinical Acute Kidney Injury

Ricksten¹,

Bragadottir²,

Redfors³

2013

Annual Update in Intensive Care and Emergency Medicine 2013

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Renal oxygenation is defi ned as the relationship between renal oxygen delivery (DO 2 ) and renal oxygen consumption (VO 2 ) and it can easily be shown that the inverse of this relationship is equivalent to renal extraction of O 2 (O 2 Ex). An increase in renal O 2 Ex means that renal DO 2 has decreased in relation to renal VO 2 , i. e., renal oxygenation is impaired, and vice versa. When compared to other major organs, renal VO 2 is relatively high, second only to the heart. In sedated, mechanically ventilated patients, renal VO 2 is two-thirds (10 ml/min) that of myocardial oxygen consumption (15 ml/min) (Table 1) [1,2]. Renal blo od fl ow, w hich accounts for approximately 20 % of cardiac output, is three times higher than myocardial blood fl ow in this group of patients. Renal O 2 Ex in the non-failing kidney is therefore low, 10 %, compared with, e.g., the heart, in which O 2 E X is 55 % (Table 1). Determin a nts of renal oxygenationIt is well known from experimental studies that tubular sodium reabsorption is the major determinant of renal VO 2 [3] and tha t under normal physiological conditions, approximately 80 % is used to drive active tubular transport of particularly sodium, but also glucose, amino acids and other solutes. Tubular transport processes are highly load-dependent and it has been shown in experimental studies [4] and in p atients [2,[5][6][7] that the re i s a close linear correlation between glomerular fi ltration rate (GFR), renal sodium reabsorption and renal VO 2 (Fig. 1). Th e fi l tered load of sodium is, thus, an important determi nant of renal VO 2 and maneuvers that decrease GFR and the tubular sodium load act to decrease tubular sodium reabsorption and renal VO 2 , and vice versa [8]. It has b een shown that renal O 2 Ex remains stable over a wide range of renal blood fl ows, which means that changes in renal DO 2 , caused by changes in renal blood fl ow, are directly off set by changes in renal VO 2 [9], i. e., r enal VO 2 is fl ow-dependent. Th us, unlike other organs where increases in blood fl ow will improve oxygenation, increased renal blood fl ow augments GFR and the fi ltered load of sodium, which will increase renal VO 2 . Due to this fl ow-dependency of renal VO 2 , renal oxygenation will re main constant, as long as renal blood fl ow and GFR change in parallel. Regional intrarenal oxygenation and medullary hypoxiaTh e relatively high renal blood fl ow is directed preferentially to the cortex to optimize the fi ltration process and solute reabsorption. In contrast, blood fl ow in the outer medulla is less than 50 % of the cortical blood fl ow to preserve osmotic gradients and to enhance urinary concentration [10]. Th e combi nation of low me dullary perfusion, high oxygen consumption of the medullary thick ascending limbs (mTAL) and the countercurrent exchange of oxygen within the vasa recta, results in a poorly oxygenated outer medulla [11]. Oxygen av ailability is, therefore, low in the outer medulla, which has an oxygen tissue partial pressure (PO 2 ) of 10-20 mm Hg ...

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Section: Eff Ects Of Diureti Cs On Renal Oxygenation In the Postoperamentioning

confidence: 99%

Section: Vasodilatory Shock and Aki: Role Of Norepinephrinementioning

confidence: 99%

Renal Oxygenation in Clinical Acute Kidney Injury

Ricksten¹,

Bragadottir²,

Redfors³

2013

Annual Update in Intensive Care and Emergency Medicine 2013

View full text Add to dashboard Cite

show abstract

“…Therefore, the use of low-dose or so called "renal-dose" dopamine, which increases the renal blood flow independent of any effect on the systemic hemodynamics, has thus been proposed. [19,20] In this study, we used low-dose dopamine for an evaluation of the renal functional reserve, because this enables us to make an accurate calculation of the dose for each patient and a comparison between the baseline and after the load values in a relatively short period of time.…”

Section: Discussionmentioning

confidence: 99%

Significance of the Renal Functional Reserve in Reflux Nephropathy: An Evaluation According to the Degree of Glomerular Damage

et al. 2007

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Objective. In the treatment of progressive reflux nephropathy (RN), the therapeutic benefit and prognosis of the renal function in RN patients appears to be influenced by the degree of renal functional reserve. We designed this study to determine the presence and characteristics of the renal functional reserve in RN patients. Materials and Methods. In the 35 RN patients with renal scars (19 males; mean age 16.1 years), an exogenous renal clearance test was performed to measure the glomerular filtration rate (GFR) and the effective renal plasma flow (ERPF). In the second half of this test, the renal functional reserve was estimated by measuring the GFR and ERPF during low-dose dopamine infusion. These measurements were then compared with the glomerular size, which had been previously determined by a renal biopsy. Results. Among the patients with a normal glomerular size (−2SD to +2SD), the GFR markedly increased after low-dose dopamine infusion (from 112.15 ± 52.51 to 182.07 ± 69.95mL/min, p < 0.0001), whereas an increase in ERPF was not significant. Among the patients with an enlarged glomerular size (+2SD to +4SD), the GFR and ERPF increased significantly over the baseline values (from 54.60 ± 32.90 to 114.00 ± 65.48 mL/min, p = 0.0076; from 281.01 ± 152.54 to 622.43 ± 392.73 mL/min, p = 0.0155, respectively). Among the patients with an extremely enlarged glomerular size (>+4SD), both the GFR and ERPF remained almost completely unchanged. Conclusion. The renal functional reserve was present even among progressive RN patients with a glomerular size ranging between +2SD and +4SD.

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“…6 Because of its specific renal effects, low-dose dopamine has been used to treat cases of suspected renal hypoperfusion and vasoconstriction, 2 factors involved in renal dysfunction and acute tubular necrosis. [7][8][9][10][11][12][13] Vasoconstriction after ischemiareperfusion in kidney transplant has been proposed to explain posttransplant kidney dysfunction. 14 Although infusion of a "renal dopamine dose" has been suggested to provide better renal tissue perfusion and better preservation of transplant function, so far, there is no clinical evidence either for or against this strategy.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Bataille

Payen²,

Villiers³

et al. 2016

Exp Clin Transplant

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Objectives: 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. 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.

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Effect of Intravenous Infusion of Low-Dose Dopamine on Renal Function in Normal Individuals and in Patients with Renal Disease

Cited by 79 publications

References 5 publications

Renal Oxygenation in Clinical Acute Kidney Injury

Renal Oxygenation in Clinical Acute Kidney Injury

Significance of the Renal Functional Reserve in Reflux Nephropathy: An Evaluation According to the Degree of Glomerular Damage

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