"Primary treatment goal in acute heart failure is to achieve adequate [urine output] while avoiding renal dysfunction and other adverse effects. Patients with acute heart failure and moderate or severe renal dysfunction are at risk for inadequate [urine output] and worsening renal function, both of which are associated with worse outcomes," according to background information in the article. "Small studies suggest that low-dose dopamine or low-dose nesiritide may enhance [urine output] and preserve renal function in patients with acute heart failure and renal dysfunction; however, neither strategy has been rigorously tested."
The multicenter, clinical trial included 360 hospitalized participants with acute heart failure and renal dysfunction.
The researchers found that compared with placebo, low-dose dopamine had no effect on 72-hour cumulative urine volume (a measure of decongestion) or on a measure of kidney function. Similarly, low-dose nesiritide had no effect on these measures. There was no effect of low-dose dopamine or low-dose nesiritide on other urine measure, weight change, renal function, or clinical outcomes, compared with placebo.
"These findings do not support the use of low-dose dopamine or low-dose nesiritide as a renal adjuvant therapy in patients with acute heart failure and renal dysfunction," the authors write.