Renal-dose dopamine: fact and fiction

Article Abstract:

Patients in intensive care units often experience a decrease in kidney function, evidenced by a decrease in urine output. It has become common to administer dopamine in such cases. Dopamine has become one of the most commonly administered drugs in critical care. Unfortunately, much of the use of dopamine is based on beliefs that are not yet supported by substantial experimental data. In the 1960s, low doses of dopamine were discovered to increase blood flow through the kidney, to increase the rate of filtration of the blood through the kidney glomerulus, and to increase the excretion of sodium in the urine. Dopamine is a member of the group of biochemical compounds called catecholamines, yet other catecholamines do not have these effects on the kidneys. Studies have clearly indicated that dopamine is beneficial in increasing urinary excretion of sodium in patients with congestive heart failure, but it is not certain to what degree these benefits extend to other conditions. There are studies indicating that patients being treated for acute kidney failure may benefit from the administration of dopamine, usually in combination with a diuretic drug. However, these studies have generally been conducted on a small number of patients without adequate control groups, and it is difficult to interpret how representative the results might be. The use of dopamine in cases of toxic injury to the kidney, or injury resulting from inadequate blood flow, is based on especially questionable data. These observations should not be taken as evidence that the use of dopamine should be abandoned, but only that it not be viewed as a firmly established treatment for kidney failure. Dopamine should be used only for patients with adequate blood volume who have not responded to diuretic treatment. If the drug does not achieve the desired result, it should be withdrawn. Furthermore, even if dopamine does prove effective, the dose should nevertheless be tapered after the first 24 hours. Only carefully designed and controlled experimental studies will establish with confidence the proper role for dopamine in the treatment of acute kidney failure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Drug therapy, Dosage and administration, Dopamine, Kidney diseases, editorial

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Familial Occurrence of Abdominal Aortic Aneurysm

Article Abstract:

The siblings of patients with abdominal aortic aneurysms appear to be at increased risk for the condition. An aneurysm is a weakened and enlarged region of a blood vessel wall. Rupture of an aneurysm in the aorta, the major artery in the body, is often fatal. Researchers examined 238 siblings of aneurysm patients and 281 people with no family history (the control group). Aortic aneurysms were detected in 11% of the siblings and in only 1.3% of the controls. The family members had four times the risk of aneurysm, and males siblings had 12 times the risk, compared to the control group.

Finland, Health aspects, Risk factors, Brothers and sisters, Aortic aneurysms, Aortic aneurysm

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