Cardiology Xagena

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Low-dose Dopamine promotes diuresis and preserves renal function in heart failure patients

Heart failure is a major health problem worldwide with no proven therapy. Low-dose Dopamine ( LDD ) has been applied to patients with heart failure to enhance diuresis and preserve renal function since the last century.
However, the efficacy of low-dose Dopamine in heart failure has been questioned by several studies recently.
The purpose of this meta-analysis is to appraise the effects of the low-dose Dopamine to heart failure.

The primary endpoints in the meta-analysis were renal function, determined by blood urea, creatinine levels, eGFR and urine output. Secondary endpoints were rates of all-cause mortality and readmission after treatment.

Six randomized controlled trials ( RCTs ) and one retrospective study involving 587 patients were included in this analysis.

Low-dose Dopamine enhanced eGFR ( MD, 7.44; 95% CI, 1.92-12.95; P=0.008 ), urine output ( SMD, 0.58; 95% CI, 0.15-1.01; P=0.008 ) and decrease creatinine levels ( MD, -0.36; 95% CI, -0.64/-0.08; P=0.004 ), blood urea ( MD, -6.97; 95% CI, -13.12/-0.81; P=0.03 ).

No statistically significant differences in the rates of mortality ( RR, 0.86; 95% CI, 0.62-1.20, P=0.37 ) and readmission ( RR: 0.86; 95% CI 0.47-1.56, P=0.62 ) were noted.

In conclusion, low-dose Dopamine indeed brought benefits in terms of promoting diuresis and preserving renal function for heart failure patients. It did not demonstrate statistical significance in rates of readmission nor mortality.
The efficacy of low-dose Dopamine to patients with heart failure should be confirmed by further large, high quality clinical trials. ( Xagena )

Xing F et al, Int J Cardiol 2016;222:1003-1011