Low dose dopamine infusion reduces renal tubular injury following cardiopulmonary bypass surgery.
BACKGROUND: The use of dopamine to protect the kidneys against hypoperfusion injury remains controversial with little clinical evidence of benefit and increasing concerns regarding safety. In this double-blind, prospective, randomised study, we investigated the effect of dopamine infusion (2.5 microg/kg/min) on glomerular filtration rate (GFR) and tubular injury in patients undergoing routine cardiopulmonary bypass (CPB). METHODS: Forty eight patients were randomly assigned to receive intravenous dopamine or saline from induction of anaesthesia until 48 hours post-operatively. There were no differences in mean age, bypass time or pre-op creatinine in the 36 patients (33 men) who completed the study. 51Cr-EDTA GFR (ml/min/1.73 m2) was measured pre-operatively and on day 5 only. Urinary markers of tubular injury (albumin, N-acetyl glucosaminidase, NAG; retinol binding protein, RBP) were measured pre-operatively, and on days 1, 2 and 5. RESULTS: GFR was preserved equally in both groups. All patients demonstrated significant tubular injury but urinary levels of NAG and RBP were lower in the dopamine group (41%, p=0.057 and 41%, p=0.007, respectively) on the first post-operative day. CONCLUSION: We conclude that low dose dopamine infusion may reduce renal tubular injury following CPB in patients with normal or near normal baseline renal function.
|Title:||Low dose dopamine infusion reduces renal tubular injury following cardiopulmonary bypass surgery.|
|Keywords:||Acute Kidney Injury, Aged, Cardiopulmonary Bypass, Cardiotonic Agents, Coronary Artery Disease, Dopamine, Double-Blind Method, Female, Glomerular Filtration Rate, Heart Valve Diseases, Humans, Infusions, Intravenous, Kidney Tubules, Male, Middle Aged, Prospective Studies, Renal Circulation, Treatment Outcome|
|UCL classification:||UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences
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