The role of α-receptor manipulation in the prevention of renal dysfunction

Abstract

There has been recent interest in the role of α-adrenoreceptor manipulation and the prevention of renal dysfunction. α2- Agonists have been used in the prevention of renal dysfunction after extracorporeal circulation. In the setting of sepsis and hypotension, α1-agonists have also been shown to be beneficial to renal function. Accordingly, we review the renal effects of α2-agonists as studied in animal models and present currently available evidence from controlled and uncontrolled human studies. Although the pathophysiology of the interaction between α -adrenoreceptor manipulation and renal function is complex, the balance of evidence suggests that central α -receptor agonists may be useful in preventing renal dysfunction as prophylactic agents before a state of a-receptor overstimulation. α -Receptor agonists administered peripherally also appear useful in states of hyperdynamic hypotension, in which α -receptors may be dysfunctional. In both cases, restoration of -α-adrenoreceptor homeostasis appears to be the key to the achievement of renal protection