Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/9974
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dc.contributor.authorJones, Daryl Aen
dc.contributor.authorBellomo, Rinaldoen
dc.date.accessioned2015-05-15T23:16:32Z
dc.date.available2015-05-15T23:16:32Z
dc.date.issued2005-07-08en
dc.identifier.citationJournal of Intensive Care Medicine; 20(4): 199-211en
dc.identifier.govdoc16061903en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/9974en
dc.description.abstractAcute renal failure (ARF) is common in the critically ill and is associated with a high mortality rate. Its pathogenesis is not understood. Because animal models use ischemia to induce experimental ARF, there is the widespread belief that lack of blood flow is responsible for ARF. Low-dose dopamine (LDD) has been shown to increase renal blood flow in animal and in human volunteers. Thus, it has been administered to humans for almost 3 decades in the belief that it would lead to renal arterial vasodilation and increase renal blood flow (RBF). However, the etiology of ARF in critical illness is likely multifactorial, and the contribution of hypovolemia and reduced renal perfusion is unknown. Furthermore, interindividual variation in the pharmacokinetics of dopamine typically results in poor correlation between blood levels and administered dose, making accurate and reliable delivery of LDD difficult. Finally, dopamine is a proximal tubular diuretic that increases Na(+) delivery to tubular cells, thus increasing their oxygen demands. Accordingly, even if LDD were able to preferentially increase RBF, there is no guarantee that it would restore renal parenchymal oxygen homeostasis. More important, 2 meta-analyses and a large double-blind, prospective, multiple-center, randomized controlled trial have failed to demonstrate that dopamine protects the kidney in critically ill patients with ARF. Currently, there is insufficient evidence to support the use of renal-dose dopamine in the intensive care unit.en
dc.language.isoenen
dc.subject.otherAcute Kidney Injury.drug therapy.physiopathologyen
dc.subject.otherAnimalsen
dc.subject.otherDopamine.administration & dosage.adverse effects.pharmacologyen
dc.subject.otherDose-Response Relationship, Drugen
dc.subject.otherEvidence-Based Medicineen
dc.subject.otherHemodynamics.drug effects.physiologyen
dc.subject.otherHomeostasis.drug effects.physiologyen
dc.subject.otherHumansen
dc.subject.otherOxygen Consumption.drug effectsen
dc.subject.otherRenal Agents.administration & dosage.adverse effects.pharmacologyen
dc.subject.otherRenal Circulation.drug effects.physiologyen
dc.titleRenal-dose dopamine: from hypothesis to paradigm to dogma to myth and, finally, superstition?en
dc.typeJournal Articleen
dc.identifier.journaltitleJournal of intensive care medicineen
dc.identifier.affiliationDepartment of Intensive Care, Melbourne University, Austin Hospital, Melbourne, Australiaen
dc.identifier.doi10.1177/0885066605276963en
dc.description.pages199-211en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/16061903en
dc.type.austinJournal Articleen
local.name.researcherBellomo, Rinaldo
item.cerifentitytypePublications-
item.languageiso639-1en-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
crisitem.author.deptIntensive Care-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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