Effect of "renal-dose" dopamine on renal function following cardiac surgery

Abstract

The efficacy of renal-dose dopamine to improve renal function or reduce renal impairment was studied in 52 patients undergoing elective coronary artery bypass surgery. The patients were prospectively randomised in a double-blind fashion to receive dopamine at 200 micrograms/min (group D) or placebo (group P) from induction for 24 hours. Although dopamine improved haemodynamics, there was no effect on urine output at 4 hours (D = 917, P = 1231 ml: P = 0.066); urine output at 24 hours (D = 3659, P = 3304 ml: P = 0.36); creatinine clearance at 0-4 hours (D = 104, P = 127 ml/min: P = 0.27); creatinine clearance on admission to ICU-4 hours (D = 94.8, P = 83.4 ml/min: P = 0.48); creatinine clearance at 20-24 hours (D = 91.2, P = 107 ml/min: P = 0.48); free-water clearance at 0-4 hours (D = 29.6, P = -59.8 ml/hr: P = 0.069); free-water clearance at 20-24 hours (D = 43.2, P = -48.9 ml/hr: P = 0.55). The incidence of transient renal impairment was similar in both groups (D = 36%, P = 50%: P = 0.65). Our study failed to demonstrate that routine prophylactic renal-dose dopamine is associated with improvement in renal function, or with prevention of transient renal impairment in patients undergoing coronary artery bypass surgery.