Dopexamine therapy for the patient with, or at risk of, acute renal failure
Date First Published:
July 13, 2007
Last Updated:
July 16, 2007
Report by:
Will Bentley, Medical Student (Manchester Royal Infirmary)
Three-Part Question:
In [adults (18+) presenting to the A&E with suspected acute renal failure] does [an infusion of dopexamine] improve [renal recovery and prognosis]?
Clinical Scenario:
A patient under your care is diagnosed with acute renal failure. You have read the most recent BETs on dopamine, but you wonder if dopexamine may have different results. You investigate.
Search Strategy:
Medline (1950- July 2007) using the OVID interface
Search Details:
[acute kidney failure.mp OR exp Kidney Failure, Acute/] AND [exp Dopamine/ OR dopexamine.mp] limit to humans and english language
Outcome:
149 papers were found, of which 6 were relevant. One was a meta analysis that included four of the other papers, and one was discarded due to poor quality.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Dopexamine and its role in the protection of hepatosplanchnic and renal perfusion in high-risk surgical and critically ill patients Renton et al | 21 papers on the effects of dopexamine in a number of clinical situations. The findings with regards to renal perfusion were identified. | Meta-analysis | Dopexamine infusion given | No significant changes in creatinine clearance or prognosis | Poor evidence base to look at |
Author Commentary:
There is a very poor evidence base on the use of dopexamine in renal patients. Despite promising laboratory results, the available clinical evidence shows no significant changes. Although more evidence is needed to say conclusively that dopexamine does not have any renal protective effect, it is likely that more evidence will show conclusively that it does not.
Bottom Line:
Dopexamine cannot be recommended for use in patients with acute renal failure.
References:
- Renton et al. Dopexamine and its role in the protection of hepatosplanchnic and renal perfusion in high-risk surgical and critically ill patients