Renal functional response to dopamine during and after arteriography in patients with chronic renal insufficiency.

Abstract

The potential renal vasodilatory effect of dopamine in improving renal function after arteriography was studied. Sixty patients with preexisting renal insufficiency were prospectively randomized into two groups. Patients in the treated group (n = 30) received an infusion of dopamine for 12 hours starting at the beginning of arteriography. Patients who received placebo infusion with arteriography (n = 30) served as controls. The study was conducted in two different time intervals. In the first interval, serum creatinine levels and 12-hour creatinine clearance values were obtained before and immediately after arteriography in 12 patients in the dopamine group and 13 patients in the control group. In the second interval, the same variables were measured before arteriography and for 3 consecutive days after arteriography in 18 patients in the dopamine group and 17 patients in the control group. Serum creatinine levels became significantly elevated in the control group on the 1st day and remained so on the 3rd day after arteriography, whereas the dopamine group did not show significant elevation of these levels. Creatinine clearance decreased in the control group on the 1st day, but this deterioration was not sustained on the 3rd day. In the dopamine group, there was no deterioration in creatinine clearance on either day, and mean effective renal plasma flow during and after arteriography was greater.

Low-dose dopamine: a systematic review

“…The study by Kapoor et al was the only study included in this meta-analysis that showed a beneficial effect of low-dose dopamine [41]. However, the four other studies included in this meta-analysis that studied the reno-protective effects of low-dose dopamine in patients receiving contrast media did not replicate these findings [39,40,42,43]. Indeed, by subgroup analysis, low-dose dopamine had no significant effect on renal function in patients receiving radiocontrast media (-11.8; 95% CI -34.4, 10.6; P=0.3).…”

“…Of these, six were excluded; the remaining 15 trials [8, 30,31,32,33,34,35,36,37,38,39,40,41,42,43] were included in this meta-analysis. Articles were excluded for the following reasons: dopamine was combined with another agent [44,45,46], outcome variables not recorded [47], and pediatric patients were studied [48,49].…”

Nefropatia induzida pelos meios de contraste radiológico após cateterismo cardíaco diagnóstico e terapêutico

“…In contrast to findings of those researchers, two prospective trials have shown that dopamine, administered at a dose of 2.5 -3.0 µg/kg/min, 12 to 24 hours following CM exposure, prevented nephrotoxicity from affecting individuals with mild renal dysfunction 112,113 . But results from these studies are limited because of the small number of patients and short follow-up.…”

Effect of Dopamine on Excretory Urographic Image Quality and the Prevention of Contrast-Induced Nephropathy in Dogs.

“…This administration rate, a dose of 3-5 µg/kg/min is often called 'renal dose' or 'low-dose' dopamine and is thought to minimize the spillover stimulation of α-and β-adrenergic receptors [12]. Weisberg et al found that low dose dopamine did not prevent the contrast media induced nephropathy [26], but Hans et al proposed that dopamine treatment protected renal function from worsening by contrast media [10]. Dopamine is the endogenous precursor of norepinephrine that stimulates β 1 -receptors and dopamine receptors [4].…”