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document
The benefit of low-dose dopamine during vigorous diuresis for congestive heart failure associated with renal insufficiency : does it protect renal function ? BACKGROUND Low-dose dopamine , a renal vasodilator , has been used empirically to improve renal function or outcome in critically ill patients with oliguria or acute renal failure . HYPOTHESIS This study was designed to investigate the efficacy of low-dose dopamine ( 2 micrograms/kg/min ) as a renal-protective agent during vigorous diuresis for congestive heart failure ( CHF ) associated with mild or moderate renal insufficiency . METHODS Of 20 study patients ( mean age 74.3 +/- 15 years ) with severe CHF , 10 ( Group A ) were randomized to a treatment strategy of intravenous bumetanide ( 1 mg b.i.d . ) alone and another 10 ( Group B ) to low-dose dopamine and a similar diuretic regimen for a duration of 5 days or less if clinical edema remitted . RESULTS Group B patients showed a significant improvement in renal function and urinary output : serum blood urea nitrogen 48.9 +/- 10.3 to 32.1 +/- 14.4 mg/dl ( p < 0.05 ) ; serum creatinine 1.97 +/- 0.24 to 1.49 +/- 0.39 mg/dl ( p < 0.05 ) ; creatinine clearance 35.6 +/- 11.6 to 48.8 +/- 12.3 ml/min ( p < 0.05 ) ; and indexed urinary output 0.56 +/- 0.16 to 2.02 +/- 0.72 ml/kg/h ( p < 0.05 ) . Group A patients showed a significant increase in urinary output but nonsignificant renal functional deterioration . CONCLUSION The renal-protective effect of low-dose dopamine in the setting of CHF and vigorous diuresis is supported by this study .
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Intervention_Pharmacological
dopamine
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Intervention_Pharmacological
dopamine
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Intervention_Pharmacological
dopamine
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Intervention_Pharmacological
bumetanide
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Intervention_Pharmacological
dopamine
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Intervention_Pharmacological
dopamine
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Outcome_Physical
renal function and urinary output
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Outcome_Physical
serum blood urea nitrogen
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Outcome_Physical
serum creatinine
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Outcome_Physical
creatinine clearance
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Outcome_Physical
indexed urinary output
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Outcome_Physical
urinary output
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Outcome_Physical
nonsignificant renal functional deterioration
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Participant_Condition
congestive heart failure
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Participant_Condition
renal insufficiency
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Participant_Condition
critically ill
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Participant_Condition
oliguria
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Participant_Condition
acute renal failure
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Participant_Sample-size
20
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Participant_Age
mean age 74.3 +/- 15 years
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Participant_Condition
severe CHF ,
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Participant_Sample-size
10