January 1990

Renal and Humoral Effects of Ibopamine, a Dopamine Agonist, in Patients With Liver Cirrhosis

Author Affiliations

From the Institute of Internal Medicine (Drs Salerno, Incerti, Badalamenti, and Lorenzano) and Second Medical Clinic (Dr Morganti), University of Milan Medical School, the Division of Nephrology and Dialysis, Ospedale Maggiore (Dr Graziani), and Simes Laboratories (Dr Ghirardi), Milan, Italy.

Arch Intern Med. 1990;150(1):65-69. doi:10.1001/archinte.1990.00390130077010

• We investigated the renal and humoral effects of short-term administration of ibopamine, an orally active dopamine agonist, in patients with liver cirrhosis. The patients were divided into two groups on the basis of sodium excretion with a constant sodium intake of 40 mEq/d. We also compared the effects of ibopamine with those induced by intravenous infusion of dopamine hydrochloride (3 μg/kg per minute) in similar patients. Ibopamine caused significant increases in urine output, glomerular filtration rate, and sodium excretion throughout the 4 hours of the trial in patients with basal sodium excretion rate greaterthan 20 mmol/d. These renal effects were associated with a significant reduction in plasma aldosterone concentration. In contrast, only a transient increase in glomerular filtration rate and a diminution in plasma aldosterone concentration were observed after ibopamine in the patients with a basal sodium excretion rate less than 20 mmol/d. The infusion of dopamine had renal effects similar to those of ibopamine in both groups of patients. These results indicate that in cirrhotic patients with normal sodium excretion, ibopamine exerts a diuretic and natriuretic effect similar to that of dopamine infusion. However, these properties of dopaminergic agents are apparently lost in patients with avid sodium retention.

(Arch Intern Med. 1990;150:65-69)