Dopamine is an inotropic agent that has vasodilatory effects at low doses. It is a common belief that low-dose dopamine may be helpful in the prevention and treatment of acute renal failure and is being widely used in these situations. Does dopamine have a beneficial effect in acute renal failure? Numerous studies in animals and a few in humans using low-dose dopamine have been reported. In this review, the authors summarize the literature and discuss the basis of this practice, which should be considered more of a myth than an ally for this purpose.
"Renal-dose" dopamine is widely used in clinical practice despite the controversial benefit in the prophylaxis and treatment of acute renal failure. Goldberg et al.[1] were the first to demonstrate the renal effects of low-dose dopamine in 1960. They found that dopamine at 100 µg/min caused increased natriuresis in patients with congestive heart failure. Still, more than 40 years since that report, low-dose dopamine for this indication remains controversial.
Infusion of dopamine in healthy animals and normal volunteers results in augmentation of renal blood flow and diuresis.[2-4] Dopamine at low doses augments renal blood flow by its action predominantly on the dopamine-1 receptors on the renal vasculature causing vasodilatation.[5] In intermediate doses it acts on the ß-adrenergic receptors and increases renal blood flow by increasing the cardiac output.[6,7] However, in higher doses dopamine acts predominantly as a vasoconstrictor by its action on α-andrenergic receptors. The distinctions between low, intermediate, and high doses are arbitrary and unclear in the literature. Generally, the low dose is considered to be