Original ArticleRenal Effects of Added Low-dose Dopamine in Acute Heart Failure Patients With Diuretic Resistance to Natriuretic PeptideKamiya, Masataka MD*; Sato, Naoki MD†; Nozaki, Ayaka MD‡; Akiya, Mai MD‡; Okazaki, Hirotake MD‡; Takahashi, Yasuhiro MD‡; Mizuno, Kyoichi MD*; Shimizu, Wataru MD*Author Information *Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan; †Department of Internal Medicine and Cardiology, Nippon Medical School, Musashi-Kosugi Hospital, Kanagawa, Japan; and ‡Department of Internal Medicine, Fraternity Memorial Hospital, Tokyo, Japan. Reprints: Masataka Kamiya, MD, Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan (e-mail: email@example.com). The authors report no conflicts of interest. Received March 12, 2014 Accepted November 07, 2014 Journal of Cardiovascular Pharmacology: March 2015 - Volume 65 - Issue 3 - p 282-288 doi: 10.1097/FJC.0000000000000193 Buy Metrics Abstract Abstract: Worsening renal function during the early phase of hospitalization is related to adverse outcomes in acute heart failure (AHF). This study aimed to clarify whether added low-dose dopamine (DA) is clinically beneficial for AHF patients with diuretic resistance to human atrial natriuretic peptide (hANP). Twenty-four AHF patients, who did not have adequate diuresis by 4 hours after administration of hANP, were randomized to a low dose of DA (1–3 μg·kg−1·min−1, n = 12) or a low dose of furosemide (10–30 mg injection, n = 12). The significant increase in mean hourly urine volume from baseline (265% ± 204% with hANP + DA; 187% ± 118% with hANP + furosemide) and improvement of dyspnea were similarly observed in both groups. Significant decreases in serum creatinine levels were observed by −14.0% ± 14.2% in the hANP + DA group compared with the hANP + furosemide group (4.5% ± 9.6%, P = 0.0011) without increases in the renotubular and myocardial markers. The incidence of worsening renal function defined as a rise in serum creatinine of >0.3 mg/dL was not observed within 3 days of admission in both groups. Added low-dose DA might not have a harmful effect on renal function and effects of diuresis and symptom relief without a significant increase in troponin-T in AHF patients with diuretic resistance to hANP. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.