OBJECTIVE: To evaluate the renal effects of low-dose dopamine in patients with sepsis syndrome or septic shock treated with catecholamines. DESIGN: Prospective, clinical study using sequential periods. SETTING: A 12-bed surgical intensive care unit in a university hospital. PATIENTS: 14 patients with sepsis syndrome and 15 patients with septic shock treated with exogenous catecholamines were studied. They had no diuretic treatment. INTERVENTION: Two periods of 2 h each with and without 2 micrograms.kg-1.min-1 of dopamine infusion. Hemodynamic and renal data were obtained at the end of each period. Measurements were repeated after 48 h of dopamine infusion in patients with sepsis syndrome. All data were evaluated by the Wilcoxon rank test. MEASUREMENTS AND RESULTS: In patients with sepsis syndrome, diuresis and creatinine clearance increased significantly by 100% and 60%, respectively, during low-dose dopamine infusion without any change in systemic hemodynamics. The renal response to dopamine decreased significantly after 48 h of dopamine infusion (P < 0.01). In patients with septic shock treated with catecholamines, no variation of either systemic hemodynamics or renal function was noted during low-dose dopamine infusion. CONCLUSION: The renal effects of low-dose dopamine in patients with sepsis syndrome decrease with time. No renal effect of low-dose dopamine was observed in patients with septic shock treated with catecholamines. These findings suggest a desensitization of renal dopaminergic receptors.
OBJECTIVE: To evaluate the renal effects of low-dose dopamine in patients with sepsis syndrome or septic shock treated with catecholamines. DESIGN: Prospective, clinical study using sequential periods. SETTING: A 12-bed surgical intensive care unit in a university hospital. PATIENTS: 14 patients with sepsis syndrome and 15 patients with septic shock treated with exogenous catecholamines were studied. They had no diuretic treatment. INTERVENTION: Two periods of 2 h each with and without 2 micrograms.kg-1.min-1 of dopamine infusion. Hemodynamic and renal data were obtained at the end of each period. Measurements were repeated after 48 h of dopamine infusion in patients with sepsis syndrome. All data were evaluated by the Wilcoxon rank test. MEASUREMENTS AND RESULTS: In patients with sepsis syndrome, diuresis and creatinine clearance increased significantly by 100% and 60%, respectively, during low-dose dopamine infusion without any change in systemic hemodynamics. The renal response to dopamine decreased significantly after 48 h of dopamine infusion (P < 0.01). In patients with septic shock treated with catecholamines, no variation of either systemic hemodynamics or renal function was noted during low-dose dopamine infusion. CONCLUSION: The renal effects of low-dose dopamine in patients with sepsis syndrome decrease with time. No renal effect of low-dose dopamine was observed in patients with septic shock treated with catecholamines. These findings suggest a desensitization of renal dopaminergic receptors.
Authors: M Waelbroeck; G Taton; M Delhaye; P Chatelain; J C Camus; R Pochet; J L Leclerc; J M De Smet; P Robberecht; J Christophe Journal: Mol Pharmacol Date: 1983-09 Impact factor: 4.436
Authors: M R Bristow; R Ginsburg; W Minobe; R S Cubicciotti; W S Sageman; K Lurie; M E Billingham; D C Harrison; E B Stinson Journal: N Engl J Med Date: 1982-07-22 Impact factor: 91.245
Authors: Christian Radke; Dagmar Horn; Christian Lanckohr; Björn Ellger; Michaela Meyer; Thomas Eissing; Georg Hempel Journal: Clin Pharmacokinet Date: 2017-07 Impact factor: 6.447