Summary
Low-dose dopamine increases both renal perfusion and sodium excretion in a dose-dependent manner. These renal effects of dopamine have facilitated the widespread use of so-called “renal dose dopamine”. However, recent clinical trials have been unable to demonstrate efficacy of dopamine in the prophylaxis or treatment of acute renal failure in critical care patients or postoperatively. Therefore, dopamine definitely should no longer be used for prophylaxis/treatment of acute renal failure because of lack of efficacy, potential side effects of dopamine use, i. e., cardiac rhythm disorders/bacterial translocation, and in addition the associated high costs.
Zusammenfassung
Niedrigdosiertes Dopamin führt dosisabhängig zu einer renalen Vasodilatation, einer Steigerung der Diurese und einer Zunahme der renalen Natriumexkretion. Diese Wirkungen haben zum weitverbreiteten Einsatz von Dopamin in „Nierendosis“ beigetragen. Allerdings haben kürzlich durchgeführte klinische Studien die Wirksamkeit von Dopamin in der Prophylaxe und/oder Therapie eines akuten Nierenversagens im Rahmen von Intensivaufenthalten bzw. postoperativer Genese nicht bestätigen können. Bei fehlendem Wirksamkeitsnachweis, den mit der Dopamingabe verbundenen Risiken wie Rhythmusstörungen oder bakterieller Translokation sowie wegen der zusätzlichen Therapiekosten sollte Dopamin somit endgültig nicht mehr weder zur Prophylaxe noch zur Therapie des akuten Nierenversagens Verwendung finden.
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Serie: Die Intensivtherapie bei akutem Nierenversagen Herausgegeben von H. Kierdorf (Braunschweig)
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Krämer, B.K., Böger, C.A., Götz, A. et al. Stellenwert von niedrigdosiertem Dopamin in der Prophylaxe oder Therapie des akuten Nierenversagens. Intensivmed 41, 616–617 (2004). https://doi.org/10.1007/s00390-004-0504-6
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DOI: https://doi.org/10.1007/s00390-004-0504-6