Renal Effects of Norepinephrine in Septic and Nonseptic Patients

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

“…Several observational studies show that noradrenaline is the vasoconstrictive agent of choice, which combines the best compromise in term of cost, safety and ease of use [111][112][113][114][115][116][117]. There is no controlled study concerning this specific point.…”

The 5-Hydroxytryptamine1A Receptor Agonist, (+)-8-Hydroxy-2-(di-n-propylamino)-tetralin, Increases Cardiac Output and Renal Perfusion in Rats Subjected to Hypovolemic Shock

“…More recent work indicates that norepinephrine has beneficial effects that include restoration of urine flow and creatinine clearance when used at appropriate doses (Albanese et al, 2004). However, the use of norepinephrine before volume restitution is strictly avoided because of case reports of severe necrotizing limb ischemia (Hayes et al, 1992).…”

Controversial Issues Concerning Norepinephrine and Intensive Care Following Severe Traumatic Brain Injury

“…function [11,32], suggesting intact autoregulation, elevating MABP from 51 ± 3 to 79 ± 7 mmHg in septic patients significantly increases urine flow and creatinine clearance [11]. This, however, is contrasted by the recently published findings that an increase in MABP from 65 to 85 mmHg does not improve renal function in septic patients [16].…”

“…Heart, Circulation, and Macrohemodynamics According to its characteristic receptor distribution, norepinephrine increases cardiac contractility (b 1 ) and peripheral resistance (a 1 receptors), thereby elevating systolic and diastolic blood pressure, increasing MABP, cardiac index, and total peripheral resistance (TPR) [7][8][9][10][11]. Pressure-dependently, coronary perfusion is improved in healthy animals [7].…”

“…Adverse effects were ruled out in a retrospective study including 200 cardiac surgery patients in whom norepinephrine infusion did not increase serum creatinine levels [32]. Under experimental and clinical septic conditions norepinephrine required to elevate MABP to 70 mmHg needs to be increased severalfold [31,11], reaching values as high as 1.3 ± 0.3 µg/kg/min (97.5 ± 22.5 µg/75 kg/min) in humans [11] Figure 3. Schematic drawing of different organ systems with their complex intra-and interorgan influences involved in norepinephrine-mediated functional circuits.…”