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
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
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