Comparative study of dopamine and mannitol effects on renal function during cardiopulmonary bypass by using N-acetyl-$beta$-D-glucosaminidase assay

Comparative study of dopamine and mannitol effects on renal function during cardiopulmonary bypass by using N-acetyl-$beta$-D-glucosaminidase assay

The protective roles of low-dose dopamine and mannitol infusion in the renal function of patients undergoing cardiovascular surgery were compared in 36 patients by measuring urine N-acetyl-b-D- glucosaminidase activity, serum and urinary creatinine, blood urea nitrogen (BUN) levels and urine output. The patients were randomly selected and received a continuous infusion of dopamine, 3 $mu$g/kg/min (Group I), mannitol, 1 mg/kg/h (Group II), no medication (Group III) before the induction of anaesthesia. Urine N- acetyl-$beta$-D-glucosaminidase activities, serum and urinary creatinine and BUN were determined preoperatively after aortic cross- clamping, and on the first and second postoperative days. Changes in urine N-acetyl- $beta$-D-glucosaminidase activity or serum and urinary creatinine, and BUN levels were not statistically significant (p>0.05) between different groups. Our results revealed that, for the protection of renal function during cardiopulmonary bypass, on comparison, the prophylactic use of "low-dose" dopamine or mannitol did not display any marked superiority.

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Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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