HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Edwin B.C. Woo Augustine T.M. Tang Ahmed El Gamel Mark T. Jones Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Woo, E. B.C. Articles by Hooper, T. L. Search for Related Content PubMed PubMed Citation Articles by Woo, E. B.C. Articles by Hooper, T. L. Related Collections Anesthesia Cardiac - pharmacology Cardiac - physiology Extracorporeal circulation

Eur J Cardiothorac Surg 2002;22:106-111
© 2002 Elsevier Science NL

Dopamine therapy for patients at risk of renal dysfunction following cardiac surgery: science or fiction?

^a Department of Cardiothoracic Surgery, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT, UK
^b Department of Cardiothoracic Surgery, Southampton General Hospital, Southampton, UK
^c Department of Cardiothoracic Surgery, King's College London, London, UK
^d Department of Chemical Pathology, Wythenshawe Hospital, Manchester, UK
^e Department of Anaesthesia, Wythenshawe Hospital, Manchester, UK

Received 13 August 2001; received in revised form 1 April 2002; accepted 3 April 2002.

* Corresponding author. Tel.: +44-161-2912511; fax: +44-161-2912530

Objectives: We aimed to evaluate the renoprotective role of renal-dose dopamine on cardiac surgical patients at high risk of postoperative renal dysfunction. The latter included older patients or those with pre-existing renal disease, elevated preoperative serum creatinine (Cr), poor ventricular function, hypertension, diabetes mellitus and unstable angina requiring intravenous therapy. Methods: Fifty patients undergoing cardiopulmonary bypass (CPB) who fulfilled the entry criteria were prospectively randomized into two groups: Group 1 received a ‘renal-dose’ (3 µg kg^-1 min^-1) dopamine infusion starting at anaesthetic induction for 48 h whilst saline infusion acted as placebo in Group 2. The anaesthetic and CPB regimes were standardized. Urinary excretion of retinol binding protein (RBP) indexed to Cr, an accurate and sensitive marker of early renal tubular damage, was assessed daily for 6 days. Additional outcome measures included daily fluid balance, blood urea and serum Cr. Statistical comparisons were made using ANOVA and Mann–Whitney U-test. Results: No significant difference was found between the groups in their age, gender, preoperative NYHA class, ejection fraction, baseline serum Cr and duration of CPB and aortic cross-clamping. Renal replacement therapy was not required in any instance. Both groups demonstrated a similar and significant rise in urinary RBP throughout the study period. Dopamine-treated patients achieved more negative average fluid balance than those on placebo (5 vs. 229 ml, P<0.05). Conclusions: Renal-dose dopamine therapy failed to offer additional renoprotection to patients considered at increased risk of renal dysfunction after CPB.

Key Words: Anaesthesia • Blood flow • Cardiopulmonary bypass • Kidney • Vasodilation

This article has been cited by other articles:

				B. Mahesh, B. Yim, D. Robson, R. Pillai, C. Ratnatunga, and D. Pigott Does furosemide prevent renal dysfunction in high-risk cardiac surgical patients? Results of a double-blinded prospective randomised trial Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 370 - 376. [Abstract] [Full Text] [PDF]

				M. H. Rosner, D. Portilla, and M. D. Okusa Analytic Reviews: Cardiac Surgery as a Cause of Acute Kidney Injury: Pathogenesis and Potential Therapies J Intensive Care Med, January 1, 2008; 23(1): 3 - 18. [Abstract] [PDF]

				Y. Abu-Omar and C. Ratnatunga Cardiopulmonary Bypass and Renal Injury Perfusion, July 1, 2006; 21(4): 209 - 213. [Abstract] [PDF]

				M. H. Rosner and M. D. Okusa Acute Kidney Injury Associated with Cardiac Surgery Clin. J. Am. Soc. Nephrol., January 1, 2006; 1(1): 19 - 32. [Abstract] [Full Text] [PDF]

				N. Gill, J. V. Nally Jr, and R. A. Fatica Renal Failure Secondary to Acute Tubular Necrosis: Epidemiology, Diagnosis, and Management Chest, October 1, 2005; 128(4): 2847 - 2863. [Abstract] [Full Text] [PDF]

				J. O. Friedrich, N. Adhikari, M. S. Herridge, and J. Beyene Meta-Analysis: Low-Dose Dopamine Increases Urine Output but Does Not Prevent Renal Dysfunction or Death Ann Intern Med, April 5, 2005; 142(7): 510 - 524. [Abstract] [Full Text] [PDF]