Revisiting the former approach: Low-dose dopamine in kidney transplant recipients

Year 2021, Volume: 34 Issue: 2, 95 - 100, 31.05.2021

Nurdan Senturk Durmus Arzu Velıoglu Hakki Arıkan Ebru Asıcıoglu Cumhur Yegen Serhan Tuglular

https://doi.org/10.5472/marumj.943134

Abstract

Objective: We aim to evaluate the effects of low-dose dopamine (LDD) infusion (0.5 – 2.5 g/kg/min) on hemodynamic status and
short-term graft function in kidney transplant recipients.
Materials and Methods: Patients who underwent kidney transplantation surgery between January 2007 and December 2016 were
included in the study. Demographic and laboratory data, presence of delayed graft function, and the rates of rejection, graft loss, and
mortality were recorded. The data were compared between patients with and without LDD treatment.
Results: A total of 126 patients were included in the study (M/F:50.8%/49.2%; mean age, 38.94 ± 11.8 years). Ninety-four patients
(74.6%) received living-donor transplants. Fifty-seven patients underwent LDD infusion in the postoperative period (LDD group),
while 69 patients did not receive LDD infusion. Demographic and laboratory data of the patients did not significantly differ between
groups. Nineteen patients in the LDD group experienced delayed graft function (p=0.039). However, these patients tended to be older,
have a longer dialysis period prior to transplantation, deceased and hypertensive donors. There was no significant difference in renal
function at 6 months after transplantation between groups.
Conclusion: Although, LDD infusion increases kidney blood flow,

Keywords

Kidney transplantation, Dopamine, Delayed graft function, Rejection

References

• Pollock DM, Arendshorst WJ. Tubuloglomerular feedback and blood flow autoregulation during DA1-induced renal vasodilation. Am J Physiol 1990;258(3 Pt 2):F627-35. doi: 10.1152/ajprenal.1990.258.3.F627
• Schenarts PJ, Sagraves SG, Bard MR, et al. Low-dose dopamine: a physiologically based review. Curr Surg 2006;63:219-25. doi: 10.1016/j.cursur.2005.08.008
• Ciapetti M, di Valvasone S, di Filippo A, Cecchi A, Bonizzoli M, Peris A. Low-dose dopamine in kidney transplantation. Transplant Proc 2009;41:4165-8. doi: 10.1016/j. transproceed.2009.08.058
• Hall J. Guyton and Hall Textbook of Medical Physiology. 13th Edition, Philadelphia: W B Saunders, 2015.
• Dalton RS, Webber JN, Cameron C, et al. Physiologic impact of low-dose dopamine on renal function in the early post renal transplant period. Transplantation 2005;79:1561-7. doi: 10.1097/01.tp.000.015.8431.81676.c4
• Spicer ST, Gruenewald S, O’Connell PJ, Chapman JR, Nankivell BJ. Low-dose dopamine after kidney transplantation: assessment by Doppler ultrasound. Clin Transplant 1999;13:479-83. doi: 10.1034/j.1399-0012.1999.130607.x
• Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med 2013;158:825-30. doi: 10.7326/0003-4819-158-11- 201306.040.00007
• Singh RP, Farney AC, Rogers J, et al. Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post-transplant outcomes. Clin Transplant 2011;25:255-64. doi: 10.1111/j.1399- 0012.2010.01241.x
• Johnston O, O’Kelly P, Spencer S, et al. Reduced graft function (with or without dialysis) vs immediate graft function—a comparison of long-term renal allograft survival. Nephrol Dial Transplant 2006;21:2270-4. doi: 10.1093/ndt/gfl103
• Schwartz LB, Gewertz BL. The renal response to low dose dopamine. J Surg Res. 1988;45:574-88. doi: 10.1016/0022- 4804(88)90147-3
• Yura T, Yuasa S, Fukunaga M, Badr KF, Matsuo H. Role for Doppler ultrasound in the assessment of renal circulation: effects of dopamine and dobutamine on renal hemodynamics in humans. Nephron 1995;71:168-75. doi: 10.1159/000188707
• Carmellini M, Romagnoli J, Giulianotti PC, et al. Dopamine lowers the incidence of delayed graft function in transplanted kidney patients treated with cyclosporine A. Transplant Proc 1994;26:2626-9. doi: Accession Number:7940818
• Dönmez A, Karaaslan D, Sekerci S, Akpek E, Karakayali H, Arslan G. The effects of diltiazem and dopamine on early graft function in renal transplant recipients. Transplant Proc 1999;31:3305-6. doi: 10.1016/s0041-1345(99)00736-8
• Grundmann R, Kindler J, Meider G, Stöwe H, Sieberth HG, Pichlmaier H. Dopamine treatment of human cadaver kidney graft recipients: a prospectively randomized trial. Klin Wochenschr 1982;60:193-7. doi: 10.1007/bf01715586
• Flancbaum L, Dick M, Choban PS, Dasta JP. Effects of lowdose dopamine on urine output in oliguric, critically ill, renal transplant patients. Clin Transplant 1998;12:256-9.
• Hosseinzadeh H, Golzari SE, Abravesh M, et al. Effect of low dose dopamine on early graft function in living unrelated kidney donors. Urol J 2012;9:389-96.
• Humar A, Johnson EM, Payne WD, et al. Effect of initial slow graft function on renal allograft rejection and survival. Clin Transplant 1997;11:623-7.
• Irish WD, Ilsley JN, Schnitzler MA, Feng S, Brennan DC. A risk prediction model for delayed graft function in the current era of deceased donor renal transplantation. Am J Transplant 2010;10:2279-86. doi: 10.1111/j.1600-6143.2010.03179.x
• O’Hara JF, Jr. Low-dose “renal” dopamine. Anesthesiol Clin North Am 2000;18:835-51, ix. doi: 10.1016/s0889- 8537(05)70197-8
• Schnuelle P, Schmitt WH, Weiss C, et al. Effects of dopamine donor pretreatment on graft survival after kidney transplantation: A randomized trial. Clin J Am Soc Nephrol 2017;12:493-501. doi: 10.2215/cjn.07600716