DOPAMINE DOES NOT ENHANCE FUROSEMIDE-INDUCED NATRIURESIS IN PATIENTS WITH CONGESTIVE-HEART-FAILURE

The objective of this study was to determine whether the addition of l ow-dose (renal-dose) dopamine to furosemide therapy enhances natriures is in patients with compensated congestive heart failure, New York Hea rt Association Class II or III, We performed a randomized, controlled, open-label, crossover study wherein urinary sodium, creatinine, and f urosemide excretion rates and GFR determined by inulin clearance rates were measured during each of three treatment interventions: furosemid e infusion alone, dopamine infusion alone, and furosemide and dopamine infusions administered concurrently. Six of eight recruited subjects (4 male, 2 female) were able to complete the study, The baseline sodiu m excretion rate after equilibration on a metabolic diet was 6.7 +/- 0 .7 mEq (mean +/- SE) over 3 h. Infusion of dopamine alone caused a sli ght nonsignificant increase in natriuresis to 36.7 +/- 8.5 mEq/3 h. Fu rosemide alone markedly increased sodium excretion to 276.6 +/- 47.2 m Eq/3 h. No significant additional increment in natriuresis occurred wh en dopamine and furosemide were administered concurrently (253.8 +/- 7 3.6 mEq/3 h). Neither dopamine, furosemide, or their coadministration affected GFR, in conclusion, infusion of low-dose dopamine does not en hance furosemide-induced urinary sodium excretion rates in patients wi th compensated congestive heart failure, New York Heart Association Cl ass II or III.