Is the administration of dopamine associated with adverse outcomes in acute renal failure?
Am Soc Nephrol J Am Soc Nephrol (abstract) (Nov) 6:460 1995 Data from a multicenter trial of the efficacy of ANP in acute renal failure were analyzed to evaluate the efficacy of dopamine. Individual investigators were permitted to use dopamine at their discretion. Surprisingly, dopamine was given to 69% of oliguric and 68% of non-oliguric patients (497 total patients). 8% had severe CHF and 30% had sepsis (conditions for which dopamine might otherwise be indicated). 21-day mortality was 31% with dopamine use, 21% without. For oliguric patients 21-day mortality was 49% with and 26% without dopamine. At 14 days more dopamine-treated patients required dialysis (47% vs 36%) regardless of ANP or placebo treatment. Therefore, dopamine was not beneficial. When the data were re-analyzed to adjust for bias in the selection of patients to receive dopamine, there was still no benefit of dopamine.
