Impairment of Renal Function After Cardiopulmonary Bypass Is Not Influenced by Dopexamine

Abstract

Introduction: The objective of this study was to evaluate the effects of dopexamine on renal function in 4 groups of patients either with or without renal dysfunction. Transient renal dysfunction is often not clinically relevant in patients with normal renal function, but it is an important clinical factor in patients with pre-existing renal failure. Dopexamine (DX) is a commonly used catecholamine which probably exerts a selective effect at the splanchnic bed. Material and Methods: 24 patients with normal renal function and 24 patients with impaired renal function (creatinine in serum ! 1.5 mg/dL) were each randomly allocated to 2 groups. Group 1 (control) without renal dysfunction and group 3 (control/ dysfunction) with renal dysfunction were considered as control groups, while the patients in DX and DX/dysfunction groups received 1 mg/kg/ min dopexamine until the end of surgery. Kidney function was investigated using standard parameters and by investigating specific proteins and enzymes. Results: All patients showed pathologic excretions of the investigated parameters during cardiopulmonary bypass (CPB) with no differences between the study groups. The distal tubule, the lysosomal regions, Henle's loop and the glomerular tuft were all damaged. Heart

Untitled

“…A randomized, placebo-controlled trial of 44 patients undergoing CABG conducted by Berendes and coworkers [50] in 1997 found improvement in creatinine clearance in the dopexamine-treated groups. However, four subsequent small randomized trials [37,48,51,52] failed to provide any evidence that the use of dopexamine improves renal function or perfusion.…”

Prevention and Treatment of Acute Kidney Injury in Patients Undergoing Cardiac Surgery: A Systematic Review

“…1). A total of 70 studies (5,554 patients) met eligibility criteria [17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86] (table 1). …”

The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society for Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury

“…Consequently, there has been substantial interest in using a “renal-dose” dopamine infusion to improve kidney perfusion and prevent acute renal injury in patients undergoing CPB. Most of the single-center randomized clinical trials 27–34 have not demonstrated benefit with dopamine infusion to prevent AKI.…”