The diuretic properties of dopamine in patients after open-heart operation

Abstract

Dopamine and dobutamine were administered to 12 patients who had undergone open cardiac operations. To eliminate the effects of variation in systemic blood flow upon renal function the drug infusion rates were adjusted to achieve equal cardiac outputs. Under conditions of equivalent systemic pressure and flow, dopamine (5.0 ± 1 μg·kg-1·min-1) and dobutamine (3.5 ± 1.8 μg·kg-1·min-1) had similar effects upon glomerular filtration rate (90 ± 29 vs. 83 ± 27 ml·min-1·1.73 m-2) and effective renal plasma flow (375 ± 119 vs. 357 ± 126 ml.·min-1·1.73 m-2. However, dopamine administration resulted in a significantly greater diuresis (2.8 ± 2.7 vs. 1.0 ± 0.3 ml/min), natriuresis (0.32 ± 0.39 vs. 0.07 ± 0.10 mEq Na+/min), and kaliuresis (0.15 ± 0.06 vs. 0.10 ± 0.03 mEq K+/min) (P < 0.05). In patients with modest depression of cardiac performance and renal vasoconstriction, dopamine's selective renal vasodilator effects were not evident. Furthermore, these data suggest that dopamine inhibits tubular solute reabsorption directly. Thus, the diuresis and natriuresis that frequently accompany dopamine administration may occur independently of any effects of dopamine upon renal blood flow.