ANALYSIS OF THE EFFECT OF LOW DOSE DOPAMINE IN TREATMENT OF PRERENAL AZOTEMIA IN ADULT PATIENTS ATTENDING NEPHROLOGY UNIT IN NAUTH, NNEWI, NIGERIA

Background: This was a conventional comparative treatment-controlled study designed to analyze the effect of dopamine infusion in the treatment of prerenal azotemia (PRA). Material and Methods: thirty randomized consecutive adult patients (group A= 15, B=15) aged 18 and 58 years with PRA were recruited. Group a received conventional treatment only (fluid replacement and frusemide), while group B received conventional treatment and dopamine. 24 hours urine volume, hemodynamic changes (pulse and blood pressure), serum electrolyte, urea, and creatinine were measured for the first 5 days of hospitalization. Duration of oliguria and hospitalization, mortality, number of patients who developed acute tubular necrosis (ATN), and or required dialysis was computed. Results: Duration of oliguria and hospitalization were shorter in group B than in group A patients (P = 0.025). The daily and hourly urine output was more in group B than in group A patients (P = 0.025). However, from the second day, patients in group B excreted more sodium than patients in group A (P = 0.001).  5 patients in group A (33.30 %) and 3 (20 %) in group B developed ATN; while 6 (40%) in group A and 4 (26.7 %) in group B developed uremic syndrome and needed dialysis (P > 0.05). 2 (13.3 %) died in group A and 1 (6.7%) in group B from uremia. Conclusion: Although dopamine infusion added to conventional treatment increased the urinary output, shortened the duration of oliguria and hospitalization in patients with PRA, Renal function, development of ATN, uremic syndrome, need for dialysis and mortality were not influenced. Hence, routine prescription of dopamine infusion in the treatment of PRA is not recommended by this study.