Comparison of the renoprotective effect of dexmedetomidine and dopamine in high-risk renal patients undergoing cardiac surgery: A double-blind randomized study

Ann Card Anaesth. 2017 Oct-Dec;20(4):408-415. doi: 10.4103/aca.ACA_57_17.

Abstract

Objective: The purpose of the current study was to compare the renoprotective effects of continuous infusion of dexmedetomidine and dopamine in high-risk renal patients undergoing cardiac surgery.

Design: A double-blind randomized study.

Setting: Cardiac Centers.

Patients: One hundred and fifty patients with baseline serum creatinine level ≥1.4 mg/dl were scheduled for cardiac surgery with cardiopulmonary bypass.

Intervention: The patients were classified into two groups (each = 75): Group Dex - the patients received a continuous infusion of dexmedetomidine 0.4 μg/kg/h without loading dose during the procedure and the first 24 postoperative hours and Group Dopa - the patients received a continuous infusion of dopamine 3 μg/kg/min during the procedure and the first 24 postoperative hours.

Measurements: The monitors included serum creatinine, creatinine clearance, blood urea nitrogen, and urine output.

Main results: The creatinine levels and blood urea nitrogen decreased at days 1, 2, 3, 4, and 5 in Dex group and increased in patients of Dopa group (P < 0.05). The creatinine clearance increased at days 1, 2, 3, 4, and 5 in Dex group and decreased in patients of Dopa group (P < 0.05). The amount of urine output was too much higher in the Dex group than the Dopa group (P < 0.05).

Conclusions: The continuous infusion of dexmedetomidine during cardiac surgery has a renoprotective effect and decreased the deterioration in the renal function in high-risk renal patients compared to the continuous infusion of dopamine.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures / methods*
  • Cardiopulmonary Bypass
  • Cardiotonic Agents / administration & dosage
  • Cardiotonic Agents / therapeutic use*
  • Creatinine / blood
  • Dexmedetomidine / administration & dosage
  • Dexmedetomidine / therapeutic use*
  • Dopamine / administration & dosage
  • Dopamine / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / therapeutic use*
  • Infusions, Intravenous
  • Kidney Diseases / complications
  • Kidney Diseases / prevention & control*
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Urea / blood
  • Urodynamics

Substances

  • Cardiotonic Agents
  • Hypnotics and Sedatives
  • Dexmedetomidine
  • Urea
  • Creatinine
  • Dopamine