Dopamine, an adrenergic neurotransmitter with specific receptors in the renal vasculature, is frequently used to combat decreases in renal blood flow that may contribute to acute renal failure. It also increases glomerular filtration and sodium excretion.
Dopamine has a very short half-life and is administered as a constant-rate infusion (CRI). Higher dosages lead to tachycardia, cardiac arrhythmias, and peripheral vasoconstriction.
Patients that do not produce urine when given dopamine alone may respond to a combination of dopamine and furosemide. Dopamine is administered as a CRI, and furosemide is given by IV bolus. If no improvement occurs within 6 hours, conversion is unlikely and infusion should be discontinued. Dialysis (hemodialysis or peritoneal dialysis) may be required to maintain these patients.
