Use of dopamine in acute renal failure unjustified

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – Results of a meta-analysis suggest that low-dose dopamine is virtually useless in patients with acute renal failure.

Use of low-dose dopamine in acute renal failure is "common practice…in a large proportion of ICUs," Dr. John A. Kellum, of the University of Pittsburgh Medical Center in Pennsylvania, pointed out in an interview with Reuters Health. But when he and a colleague, Janine M. Decker, pooled data on 1019 patients in 24 studies, they found no evidence to support dopamine's use for prevention or treatment of renal dysfunction.

The results showed that dopamine had no effect on the development or progression of renal failure, mortality, or need for dialysis, the researchers report in the August issue of Critical Care Medicine. "Dopamine seems to be a relatively safe agent, although totally ineffective for preventing or treating renal failure," they write.

Based on the findings, use of low-dose dopamine cannot be justified for renal dysfunction, they conclude.

Dr. Maria I. Rudis, of the University of Southern California School of Pharmacy in Los Angeles, agrees. In a commentary, she notes that the meta-analysis supports results from the recently reported Australian and New Zealand Intensive Care Study. In this large, prospective, randomized, double-blind trial, 2 µg/kg/min dopamine was ineffective in 324 ICU patients with renal dysfunction.

Dr. Rudis concludes that the "unsubstantiated use of low-dose dopamine is no longer defensible."

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