Dopamine in the Hepatorenal Syndrome

John R. Wilson, MD
JAMA. 1977;238(25):2719-2720. doi:10.1001/jama.1977.03280260049018.
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DOPAMINE hydrochloride has been reported to increase both renal plasma flow and, to a small extent, urinary sodium excretion in patients with the hepatorenal syndrome, but to have no notable effect on glomerular filtration rate or urinary output.1,2 A patient with the hepatorenal syndrome had a clear increase in urine output and urinary sodium excretion resulting from the use of dopamine.

Report of a Cas  A 50-year-old woman with a history of heavy alcohol abuse was admitted with marked jaundice, massive ascites, and moderate pedal edema. The laboratory findings disclosed the following values: BUN, 5 mg/dl; creatinine, 0.8 mg/dl; total bilirubin, 20.8 mg/dl; SGOT, 282 μU/ml (normal 7 to 40 μU/ml); alkaline phosphatase, 234 μU/ml (normal 30 to 125 μU/ml); and urinary sodium, 3 mEq/liter. The patient began receiving a 500-mg sodium diet, and 1,200 ml fluid restriction.On the ninth hospital day, asterixis, and mild confusion were noted.


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