The kidneys possess a dopaminergic system that seems to be independent from neural dopamine systems. Due to the actions of dopamine on the dopaminergic system and interactions with other systems (mainly adrenergic), dopamine represents a key drug in the regulation of blood pressure levels in patients with hemodynamic instability and hypotension. Stimulation of dopamine in D1-like and D2-like receptors induces natriuresis, diuresis, and improvement of renal blood flow through vasodilation (preferably of the afferent renal arteriole). For this reason, dopamine is used at low levels to promote diuresis and at high levels to increase blood pressure.
Aim of the work
To evaluate the effects of dopamine (2 mg/kg/min) on systemic hemodynamics (heart rate, HR, central venous pressure, CVP), creatinine clearance (CLcr), diuresis and fractional sodium excretion (FENa+) in comparison with Fursoemide.
Patients
This multi-centered study will be carried out over a period of four months at critical care units in Alexandria university hospitals.
Approval of the Medical Ethics Committee of Alexandria Faculty of Medicine. An informed consent will be taken from the patients' next of kin before their enrollment in the study.
Exclusion criteria: Patients aged below 18 years, Patient with severe pulmonary hypertension, ESRD patients on Haemodialysis, AKI due to obstructive uropathy, Toxin induced AKI, Chronic AF patients and Patients with contraindications for bladder catheterization