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 μg/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.