Friday, November 29, 2013
Dopamine or Nesiritide Does Not Improve Kidney Function in Acute Heart Failure Patients
In 360 hospitalized acute heart failure patients with kidney dysfunction, neither low-dose dopamine nor low-dose nesiritide (recombinant B-type natriuretic peptide) enhanced decongestion or improved renal function when added to diuretic therapy. The JAMA findings come from the multicenter, double-blind, placebo-controlled Renal Optimization Strategies Evaluation (ROSE) trial. Guidelines for acute heart failure management state that use of low-dose dopamine to improve diuresis and preserve renal function during diuretic therapy may be considered, but the ROSE trial findings do not provide support for this strategy in patients with renal dysfunction who are at risk for inadequate decongestion and worsening renal function.
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