RENAL DOSE DOPAMINE IN SURGICAL PATIENTS - DOGMA OR SCIENCE

Objective ''Renal dose'' dopamine is widely used in the perioperative I period to provide renal protection. A comprehensive review of the li terature was performed to determine whether dopamine does in fact conf er protection on the kidneys of surgical patients. Summary Background Data Studies in healthy animals and human volunteers reveal that dopam ine causes diuresis and natriuresis, as well as some degree of renal v asodilatation. Results Studies of the perioperative use of dopamine fa il to demonstrate any benefit of dopamine in preventing renal failure. Studies in congestive heart failure, critical illness, and sepsis als o fail to show any benefit of dopamine other than diuresis. Further, d opamine administration is not completely without risk, because of dopa mine's catecholamine and neuroendocrine functions. Conclusions Routine use of prophylactic ''renal dose'' dopamine in surgical patients is n ot recommended.