Use of dopamine in acute renal failure: A meta-analysis

    loading  Checking for direct PDF access through Ovid

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.

Related Topics

    loading  Loading Related Articles