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[Dopamine and kidney in sepsis: a systematic review]
Denise Varella Katz1, Eduardo Juan Troster, Flavio Adolfo Costa Vaz
1Unidade de Terapia Intensiva do Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
Unlabelled:
Acute renal failure has a high morbidity and mortality in critically ill patients. Severe sepsis and septic shock are important risk factors for the development of acute renal failure. Low-dose dopamine (0.5 to 3 mg/kg/min) has been used for decades as a renal-protective therapy in such patients, even in the absence of any controlled study to support this concept.
Background:
To Check the literature for evidences supporting the routine use of low-dose dopamine in severe sepsis and septic shock.
Methods:
Systematic review of the literature, on electronic databasis (MEDLINE, EMBASE and LILACS), and handsearching.
Results:
Only five randomized clinical trials were found, but none of them studied renal outcomes. Eight cases series studies were included on a qualitative review. Dopamine was associated with some adverse effects, such as increase in pulmonary shunting, tachyarrhythmias, and increase in pulmonary artery pressure, that were not statistically significant. Mortality also did not change with the use of dopamine.
Conclusions:
There are no sufficient evidences in the literature to support the routine use of low-dose dopamine as a renal protective agent in severe sepsis and septic shock.