The Effect of Low-Dose Dopamine on the Renal Function of Asphyxiated Neonates

Nam, Seung Yeon; Park, Eun Ae; Lee, Seung Joo

Abstract

PURPOSE: Low-dose dopamine (0.5-3 microgram/kg/min) increases renal blood flow, glomerular filtration rate and natriuresis and has protective and therapeutic effects on oliguric renal failures. Asphyxia is the most common cause of acute renal failure in neonates. But the protective effects of dopamine have never been reported in asphyxiated neonates. So we reported the effects of low-dose dopamine on the renal function of asphyxiated neonates.
METHODS
Twenty-seven asphyxiated neonates who were admitted to the neonatal intensive care unit of Ewha Womans University hospital, from September, 1995 to June, 1997, were randomized to dopamine group (N=14, dopamine 0.5-3 microgram/kg/min) and control group (N=13). Serum creatinine (Pcr) and Na (PNa), urine creatinine (Ucr) and Na (UNa), urine output, creatinine clearance rate (Ccr), fractional excretion of Na (FENa) of two groups were compared on postnatal day 1, 3, 5. Incidences of acute renal failure and neonatal complications were also checked.
RESULTS
The postnatal changes of Pcr (mg/dL), Ccr (mL/min/1.73m2) and FENa (%), on lst, 3rd & 5th days were not significnatly diffrent between dopamine group and control group. The postnatal changes of UNa (mmol/day) and urine output (ml/kg/hr) in dopamine group on 1st, 3rd & 5th days were significantly higher than those of control group (P<0.05). The incidence of acute renal failure, intraventricular hemorrhage, bronchopulmonary dysplasia, patient ductus arteriosus, sepsis and necrotizing enterocolitis were not significantly different between two groups.
CONCLUSION
Low-dose dopamine, which was prophylactically given after birth in asphyxiated neonates, showed natriuretic and diuretic effects without significant increase of glomerular function.