December 19, 1977

Dopamine in the Hepatorenal Syndrome

Author Affiliations

From the Department of Medicine, Cleveland Metropolitan General Hospital, Cleveland. Dr Wilson is now with the Cardiovascular Section, Hospital of the University of Pennsylvania, Philadelphia.

JAMA. 1977;238(25):2719-2720. doi:10.1001/jama.1977.03280260049018

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.