Nephrology Dialysis Transplantation, Vol 12, Issue 12 2667-2672, Copyright © 1997 by Oxford University Press
M Pestana, M Faria, J Oliveira, J Baldaia, A Santos, L Guerra and P Soares-da-Silva
Background: The urinary excretion of free dopamine has
been used as an index of the renal synthesis of amine. However, it is now
well recognized that in the kidney, newly-formed dopamine is significantly
inactivated through deamination to 3,4-dihydroxyphenylacetic acid (DOPAC)
by monoamine oxidase (MAO). The aim of the present study was to assess the
renal dopaminergic system activity during the recovery of renal function in
kidney transplant recipients and to assess which parameters are appropriate
for the evaluation of renal amine synthesis under these conditions.
Methods: Twenty-four-hour urinary excretion of
L-DOPA, dopamine and its metabolites (DOPAC; 3-MT;
HVA) were continuously monitored in 19 renal transplant recipients from the
first day of surgery until the twelfth day post-transplantation.
Results: In 11 patients (group 1), renal function
consistently recovered throughout the study (plasma creatinine levels
decreased from 6.2±0.4 to 2.1±0.1 mg/dl). Eight
patients presented with acute tubular necrosis (Group 2) and minimal renal
function was maintained until the twelfth post-operative day. The urinary
excretion of L-DOPA did not differ throughout the
study between the two groups of patients. In contrast, the 24-h urinary
levels of dopamine, DOPAC and HVA were significantly higher throughout the
study in patients of Group 1: dopamine (Group 1, 179±26 to
422±51 nmol/24 h; Group 2, 25±3 to 57±13
nmol/24 h), DOPAC (Group 1, 698±57 to 3487±414
nmol/24 h; Group 2, 158±22 to 1014±193 nmol/24 h) and
HVA (Group 1, 13058±1199 to 20387±1559 nmol/24; Group
2, 4140±848 to 15219±1037 nmol/24 h).
Conclusions: The recovery of renal function in renal
transplant recipients is accompanied by an enhanced ability to synthesize
dopamine and inactivate it to DOPAC and HVA. It is suggested that the
urinary levels of DOPAC may be a useful parameter for the assessment of
dopamine formation in renal tissues. Key words:
dopamine; DOPAC; HVA; kidney; L-DOPA;
transplantation
ORIGINAL ARTICLES
Assessment of renal dopaminergic system activity during the recovery of renal function in human kidney transplant recipients
Nephrology Unit andInstitute of Pharmacology and Therapeutics, Faculty of Medicine, P-4200 Porto, Portugal; Corresponding author
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