muramidase and Heart-Diseases

Thirty-six patients with preoperative renal dysfunction were studied to evaluate the effects of dopamine (D) and dopamine-nitroprusside (DN) on renal function during cardiopulmonary bypass (CPB). No differences from the control group (C) were found in creatinine clearance, fractional sodium excretion, osmolarity and free-water clearance. Sodium output/intake ratio during CPB was higher in group D than in groups C and DN (P less than 0.05); water output/intake ratio was higher in group D than in group C (P less than 0.05). Urine lysozime levels and alpha-glycosidase/creatinine ratios increased similarly in the three groups, suggesting ischemic tubular cell damage. No patients showed acute postoperative renal failure or a worsening of their renal dysfunction. The data suggest an increased water and sodium excretion during CPB with a dopamine infusion, possibly resulting from a renal vasodilator effect that was abolished by simultaneous nitroprusside administration.

Topics: Aged; Body Water; Cardiopulmonary Bypass; Creatinine; Diuresis; Dopamine; Drug Synergism; Drug Therapy, Combination; Glomerular Filtration Rate; Glycoside Hydrolases; Heart Diseases; Humans; Infusions, Intravenous; Kidney Diseases; Kidney Tubules; Middle Aged; Muramidase; Nitroprusside; Osmolar Concentration; Prospective Studies; Sodium