DOPAMINE

• "Renal-dose" Dopamine--Refers to IV infusion at a low rate; traditionally used to treat incipient or early Acute Renal Failure because of observations that it increases renal blood flow and urine output. However:

 Meta-analysis of low dose DA [61 trials], no affect on all cause mortality, adverse events, need for renal replacement tx.  + stat sig increase in UO and CrCl.  [Annal Int Med 4/5/05;142:510-24].  

A meta-analysis of 17 randomized trials involving about 600 pts (looking at significant endpoints, e.g. death, development of ARF, or need for dialysis) found only statistically insignificant benefits from renal-dose Dopamine vs. placebo (e.g. mortality 4.7% vs. 5.6%, ARF 15.3% vs. 19.5%, dialysis 13.9% vs. 16.5%) (Crit. Care Med. 29:1526, 2001--JW)

A randomized trial in 328 critically ill pts with early renal dysfunction also showed no sig. benefit (Lancet 356:2139, 2000--JW)