The effect of ‘renal-dose’ dopamine on renal tubular function following cardiac surgery: assessed by measuring retinol binding protein (RBP)1

Tang, Augustine; El‐Gamel, Adam; Keevil, Brian; Yonan, N.; Deiraniya, Abdullah K.

doi:10.1016/s1010-7940(99)00081-0

Cited by 84 publications

(38 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some authors have reported an increase of urine output after dopamine administration 8,28 while others described no effect. [29][30][31] In our study, cumulative urine output was not increased by dopamine, contrary to diltiazem. More specific markers of renal integrity are necessary to completely assess the worth of different renal protective strategies.…”

Section: Discussioncontrasting

confidence: 46%

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

Piper

Kumle

Maleck

et al. 2003

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

P Pu ur rp po os se e: : To evaluate the influence of dopamine and diltiazem on renal function and markers for acute renal failure, including urinary alpha-glutathion s-transferase (α-GST), alpha-1-microglobulin (α 1 -MG) and N-acetyl-ß-glucosaminidase (ß-NAG) after extracorporeal circulation.M Me et th ho od ds s: : In a randomized, placebo-controlled, double-blind trial we evaluated the efficacy of dopamine (2.5 µg·kg -1 ·min -1 ), diltiazem (2 µg·kg -1 ·min -1 ) or placebo administered over 48 hr postoperatively to maintain renal tubular integrity in 60 elective cardiac surgery patients. α-GST, α 1 -MG, ß-NAG, and creatinine clearance were measured from urine collected during surgery (T0), the first four hours (T1), 24 hr (T2) and 48 hr (T3) postoperatively.R Re es su ul lt ts s: : Cumulative urine output in the diltiazem group (9.0 ± 2.8 L) increased significantly compared with placebo (7.0 ± 1.6 L), but not compared with dopamine (7.8 ± 1.8 L). Creatinine clearance showed no significant intergroup differences. In all groups α 1 -MG increased from T0 to T3, but we found no significant intergroup differences. α-GST increased significantly from T0 to T3 in the placebo (2.1 ± 1.8 to 11.4 ± 8.6 µg·L -1 ) and in the dopamine groups (2.7 ± 1.8 to 13.6 ± 14.9 µg·L -1 ), but not in the diltiazem group (1.8 ± 1.4 to 3.2 ± 3.2 µg·L -1 ). Forty-eight hours postoperatively α-GST was significantly lower in the diltiazem group than in both other groups.C Co on nc cl lu us si io on ns s: : Diltiazem stimulates urine output, reduces excretion of α-GST and ß-NAG and may be useful to maintain tubular integrity after cardiac surgery. Objectif : Évaluer l'influence de la dopamine et du diltiazem sur la fonction rénale et les paramètres de l`insuffisance rénale aiguë, y compris l'alpha-glutathion S-transférase (α -GST), l'alpha-microglobuline (α 1 -MG) et la N-acétyl-ß glucosaminidase (ß-NAG) urinaires après circulation extracorporelle. Méthode : Soixante patients opérés pour un pontage aortocoronarien ont participé à un essai randomisé en double aveugle et contrôlé contre placebo pour mesurer l'efficacité de la dopamine (2,5 µg kg -1 min -1 ), du diltiazem (2 µg kg -1 min -1 ) ou d'un placebo administrés pendant 48 h postopératoires pour maintenir l'intégrité tubulaire rénale. L' α-GST, l' α 1 -MG et la ß-NAG et la clairance de la créatinine ont été mesurés dans l'urine recueillie pendant l'intervention chirurgicale (T0), quatre heures (T1), 24 h (T2) et 48 h (T3) après l'opération.Résultats : L'excrétion urinaire cumulative a augmenté significativement dans le groupe diltiazem (9,0 ± 2,8 L) comparé au groupe placebo (7,0 ± 1,6 L) mais ne différait pas dans le groupe dopamine (7,8 ± 1,8 L). Il n'y avait pas de différence significative intergroupe concernant la clairance de la créatinine. Tous les groupes montraient une augmentation d' α 1 -MG de T0 à T3, sans aucune différence significative entre les groupes. L' α-GST a augmenté de manière significative de T0 à T3 dans les groupes placebo (2,1 ± 1,8 à 11,4 ± 8,6 µg L -1 ) et d...

show abstract

Section: Discussioncontrasting

confidence: 46%

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

Piper

Kumle

Maleck

et al. 2003

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Dopamine Agonists. Despite the known ability of dopamine to increase renal blood flow at low doses, multiple studies of dopamine in cardiac and noncardiac surgical populations have failed to show a benefit in terms of either mortality or renal function (195)(196)(197)(198). Fenoldopam, a selective DA 1 agonist, has showed some promise in small studies (not all of them randomized) (199)(200)(201)(202), although this has not been universal (203).…”

Section: Current and Future Pharmacologic Strategiesmentioning

confidence: 99%

AKI Associated with Cardiac Surgery

Thiele¹,

Isbell²,

Rosner

2015

Clinical Journal of the American Society of Nephrology

261

198

View full text Add to dashboard Cite

Approximately 18% of patients undergoing cardiac surgery experience AKI (on the basis of modern standardized definitions of AKI), and approximately 2%-6% will require hemodialysis. The development of AKI after cardiac surgery portends poor short-and long-term prognoses, with those developing RIFLE failure or AKI Network stage III having an almost 2-fold increase in the risk of death. AKI is caused by a variety of factors, including nephrotoxins, hypoxia, mechanical trauma, inflammation, cardiopulmonary bypass, and hemodynamic instability, and it may be affected by the clinician's choice of fluids and vasoactive agents as well as the transfusion strategy used. The risk of AKI may be ameliorated by avoidance of nephrotoxins, achievement of adequate glucose control preoperatively, and use of goal-directed therapy hemodynamic strategies. Remote ischemic preconditioning is an exciting future strategy, but more work is needed before widespread implementation. Unfortunately, there are no pharmacologic agents known to reduce the risk of AKI or treat established AKI.

show abstract

“…Many strategies have been proposed for preventing ARF, most of which focus on enhancing renal perfusion or reducing renal oxygen consumption [5], but no strategy has irrefutably been of benefit in preventing ARF. Mannitol, an osmotic diuretic, was the earliest pharmacological agent used for prophylaxis of ARF following cardiac surgery [6], but its usefulness has been debated ever since.…”

mentioning

confidence: 99%

The effect of mannitol on renal function after cardiopulmonary bypass in patients with established renal dysfunction*

Smith¹,

Best²,

Sheppard³

et al. 2008

Anaesthesia

View full text Add to dashboard Cite

SummaryThe usefulness of mannitol in the priming fluid for cardiopulmonary bypass is uncertain in patients with normal renal function, and has not been studied in patients with established renal dysfunction. We studied 50 patients with serum creatinine between 130 and 250 lmol.l )1 having cardiac surgery. Patients were randomised to receive mannitol 0.5 g.kg, or an equivalent volume of Hartmann's solution, in the bypass prime. There were no differences between the groups in plasma creatinine or change in creatinine from baseline, urine output, or fluid balance over the first three postoperative days. We conclude that mannitol has no effect on routine measures of renal function during cardiac surgery in patients with established renal dysfunction.

show abstract

The effect of ‘renal-dose’ dopamine on renal tubular function following cardiac surgery: assessed by measuring retinol binding protein (RBP)1

Cited by 84 publications

References 20 publications

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

RETRACTED ARTICLE: Diltiazem may preserve renal tubular integrity after cardiac surgery

AKI Associated with Cardiac Surgery

The effect of mannitol on renal function after cardiopulmonary bypass in patients with established renal dysfunction*

Contact Info

Product

Resources

About