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The Journal of Cardiovascular Surgery 2002 February;43(1):25-30

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Renal dose dopamine in open heart surgery. Does it protect renal tubular function?

Yavuz S., Ayabakan N., Dilek K., Özdemir A.

From the Department of Cardiovascular Surgery Bursa Yüksek Ihtisas Hospital, Bursa, Turkey *Department of Nephrology Uludag University School of Medicine, Bursa, Turkey


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Background. This pros­pec­tive, ran­dom­ized ­study ­assessed ­the ­effect of dop­a­mine on ­renal tubu­lar func­tion in ­patients ­who ­had cor­o­nary ­artery ­bypass graft­ing.
Methods. Two ­groups of ­patients ­with nor­mal pre­op­er­a­tive ­renal func­tion ­were ran­dom­ly divid­ed ­into a dop­a­mine ­group (n=11), ­who ­received dop­a­mine in a ­dose of 2 μg/kg·­min, ­and a con­trol ­group (n=11), ­who ­received no treat­ment. Dopamine infu­sion ­was initiat­ed 24 ­hours ­before ­the oper­a­tion ­and ­was con­tin­ued ­for 48 ­hours post­op­er­a­tive­ly. Measurements of ­renal func­tion ­obtained 2 ­days ­before ­the oper­a­tion ­were con­sid­ered pre­op­er­a­tive ­and ­were repeat­ed on ­the 1st, 3rd, ­and 7th post­op­er­a­tive ­days. Urinary excre­tion of β2-Microglo-bulin (β2-M), con­sid­ered a sen­si­tive ­means ­for diag­nos­ing prox­i­mal tubu­lar dam­age, ­was meas­ured dur­ing ­the ear­ly (day 3) ­and ­late (day 7) post­op­er­a­tive peri­od.
Results. There ­were no sig­nif­i­cant dif­fer­enc­es ­respect to ­the clear­anc­es of crea­ti­nine, osmot­ic, ­and ­free-­water in ­the dop­a­mine ­group com­pared ­with ­the con­trol ­group (p>0.05). Urine micro­al­bu­min lev­els sig­nif­i­cant­ly ­increased on post­op­er­a­tive ­day 3 in ­both ­groups. During ­the ear­ly post­op­er­a­tive peri­od, excre­tion of ­urine β2-M ­was sig­nif­i­cant­ly great­er in ­the dop­a­mine ­group ­than in ­the con­trol ­group (p<0.05).
Conclusions. Consequently, in ­patients ­with nor­mal pre­op­er­a­tive ­renal ­and car­diac func­tion sched­uled ­for elec­tive cor­o­nary ­artery ­bypass graft­ing, ­renal ­dose dop­a­mine infu­sion ­alone ­may ­not pro­vide suf­fi­cient pro­tec­tion on tubu­lar func­tion ­and increas­es ­renal tubu­lar inju­ry dur­ing ­the ear­ly post­op­er­a­tive peri­od.

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