Use of dopamine in acute renal failure: a meta-analysis.

Abstract

OBJECTIVE:

To determine whether low-dose dopamine administration reduces the incidence or severity of acute renal failure, need for dialysis, or mortality in patients with critical illness.

DATA SOURCES AND STUDY SELECTION:

We performed a MEDLINE search of literature published from 1966 to 2000 for studies addressing the use of dopamine in the prevention and/or treatment of renal dysfunction.

DATA EXTRACTION:

Data were abstracted regarding design characteristics, population, intervention, and outcomes. Results of individual randomized clinical trials were pooled using a fixed effects model and a Mantel-Haenszel weighted chi-square analysis.

DATA SYNTHESIS:

We identified a total of 58 studies (n = 2149). Of these, outcome data were reported in 24 studies (n = 1019) and 17 of these were randomized clinical trials (n = 854). Dopamine did not prevent mortality, (relative risk, 0.90 [0.44-1.83]; p =.92), onset of acute renal failure (relative risk, 0.81 [0.55-1.19]; p =.34), or need for dialysis, (relative risk, 0.83 [0.55-1.24]; p =.42). There was sufficient statistical power to exclude any large (>50%) effect of dopamine on the risk of acute renal failure or need for dialysis.

CONCLUSIONS:

The use of low-dose dopamine for the treatment or prevention of acute renal failure cannot be justified on the basis of available evidence and should be eliminated from routine clinical use.

• Authors: J A Kellum, J M Decker
• Journal: Critical care medicine (Crit Care Med) Vol. 29 Issue 8 Pg. 1526-31 (Aug 2001) ISSN: 0090-3493 [Print] United States
• PMID: 11505120 (Publication Type: Journal Article, Meta-Analysis)

Chemical References

• Cardiotonic Agents
• Dopamine

Topics

• Acute Kidney Injury (drug therapy, mortality, therapy)
• Cardiotonic Agents (therapeutic use)
• Dopamine (therapeutic use)
• Humans
• Randomized Controlled Trials as Topic
• Renal Dialysis
• Treatment Outcome