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THE JOURNAL OF CARDIOVASCULAR SURGERY

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

lingua: Inglese

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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