Age-dependent renal effects of intrarenal dopamine infusion

Pelayo, Juan C.; Fildes, Robert D.; José, Pedro A.

doi:10.1152/ajpregu.1984.247.1.r212

Cited by 18 publications

(13 citation statements)

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“…In support of the latter hypothesis are the studies by Gootmann et al [ 17], Dris coll et al [18] and Pelayo at al. [19] demon strating that the vasodilating response to do pamine is underdeveloped at birth and slowly matures with postnatal age. The ab sence of renal vasodilatation in normoxemic has been shown to significantly depress so dium reabsorption at doses of 10 pg/kg/min [20] .…”

Section: Pah Discussionmentioning

confidence: 99%

Failure of Dopexamine to Protect the Hypoxemic Newborn Rabbit Kidney

Jaton

Thonney²,

Guignard³

1991

Dev Pharmacol Ther

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The renal effects of dopexamine, a new dopaminergic agonist devoid of any α-adrenergic effect, were studied in 11 anesthetized newborn rabbits undergoing an acute hypoxemic normocapnie stress. Acute hypoxemia (PaO(2) = 41 mm Hg) was associated with a marked increase in renal vascular resistance and a consequent decrease in glomerular filtration rate and renal blood flow. These changes were not modified by the administration of dopexamine at 10 μg/kg/min. Failure of dopexamine to blunt the hypoxemia-induced vasoconstriction suggests vascular dopaminergic receptor immaturity.

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Section: Pah Discussionmentioning

confidence: 99%

Failure of Dopexamine to Protect the Hypoxemic Newborn Rabbit Kidney

Jaton

Thonney²,

Guignard³

1991

Dev Pharmacol Ther

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“…Interestingly, the renal response to low-dose dopamine is age dependent in animals. This is interpreted as a maturation process of renal dopamine receptors (6)(7)(8). However, premature neonates with respiratory distress syndrome receiving 2 pg/kg/min of dopamine increased their natriuresis compared to a matched control group not treated by dopamine (28).…”

Section: Discussionmentioning

confidence: 99%

“…A considerable amount of data supports its use in adults (1-5) but hemodynamic and renal effect of dopamine have not yet been assessed in children. Some animal (6)(7)(8) and clinical studies (9) suggest that differences in response to dopamine exist between adults and pediatric patients.…”

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confidence: 99%

Effect of Low Dose Dopamine on Hemodynamic and Renal Function in Children

et al. 1989

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ABSTRACT. The purpose of the study was to investigate the effect of low doses of dopamine in children. Fourteen cases were studied after open heart surgery. Cardiac output and renal parameters were determined under baseline conditions and under continuous infusion of dopamine 2.5 and 5 ~g/kg/min. During the control period cardiac index was 2.62 f 0.19 L/min/m2, renal plasma flow was decreased at 269 f 41 mL/min/1.73 m2, GFR was 86.6 2 9.2 mL/min/ 1.73 m2, and filtration fraction was elevated at 37.1 f 1.9%. Plasma concentration of aldosterone correlated with the filtration fraction. At 5 pg/kg/min dopamine increased significantly cardiac output, renal plasma flow, and to a lesser extent GFR, thus decreasing the filtration fraction. At 2.5 pg/kg/min dopamine, increased renal plasma flow only in patients older than 5 y and had no effect on the other parameters. The increase of cardiac output in response to dopamine was abolished by propanolol pretreatment. By contrast, the hemodynamic renal response to dopamine was not altered by P-blockade. These results indicate that 5 wg/kg/min of dopamine could prevent renal failure after open heart surgery in children by increasing renal blood flow and attenuating renal compensatory mechanisms. (Pediatr Res 26:200-203,1989) Abbreviation PAH, para-aminohippurateIn the presence of reduced cardiac output, dopamine is frequently used for both its positive cardiac inotropic and its renal vasodilatory effects. A considerable amount of data supports its use in adults (1-5) but hemodynamic and renal effect of dopamine have not yet been assessed in children. Some animal (6-8) and clinical studies (9) suggest that differences in response to dopamine exist between adults and pediatric patients.After open heart surgery, cardiac output and systemic pressure are often depressed. Renal failure develops in 3 to 20% of patients depending on the criteria used and the patient population. It markedly influences the ultimate prognosis (10-1 5).Our study was designed to test the effect of a continuous infusion of dopamine, 2.5 and 5.0 pg/kg/min, on hemodynamic and renal function in children after open heart surgery. renal function before the operation. The group consisted of eight girls and six boys aged 18 mo to 15 y. The clinical characteristics and the preoperative plasma creatinine concentrations are given in Table I. All the patients had normal urinalysis with negative or trace proteinuria. Before the operation, six children with tetralogy of Fallot were treated with 1 to 4 mg/kg/day of propranolol to prevent hypoxic spells; the drug was stopped 8 h before the beginning of the operation. The surgery was performed with cardiopulmonary bypass, deep hypothermia (1 8 to 24"C), and moderate hemodilution (20 to 30%).Cold chemical cardioplegia was used to obtain asystole. When cardiopulmonary bypass was discontinued, blood was infused until the left atrial pressure reached 9.5 to 12.5 mm Hg, and a single dose of furosemide (1 mg/kg) was given.Method. After the operation, a Swan-Ganz catheter (5 F...

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“…The metaanalysis by Kellum and Decker is further complicated by the fact that seven of the studies included were non-randomized trials and that two of the studies enrolled pediatric patients. Neonates and infants do not have the same dopamine-receptor profile as adults and may not show the same renal response to low-dose dopamine [27,28,29]. The aim of this meta-analysis was to determine the treatment effect of low-dose dopamine in various groups of adult patients at risk of deterioration in renal function.…”

Section: Introductionmentioning

confidence: 99%