Published online May 6, 2015. doi: 10.5527/wjn.v4.i2.196
Peer-review started: April 30, 2014
First decision: July 18, 2014
Revised: January 22, 2015
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: May 6, 2015
Fluid homeostasis, blood pressure and redox balance in the kidney are regulated by an intricate interaction between local and systemic anti-natriuretic and natriuretic systems. Intrarenal dopamine plays a central role on this interactive network. By activating specific receptors, dopamine promotes sodium excretion and stimulates anti-oxidant and anti-inflammatory pathways. Different pathological scenarios where renal sodium excretion is dysregulated, as in nephrotic syndrome, hypertension and renal inflammation, can be associated with impaired action of renal dopamine including alteration in biosynthesis, dopamine receptor expression and signal transduction. Given its properties on the regulation of renal blood flow and sodium excretion, exogenous dopamine has been postulated as a potential therapeutic strategy to prevent renal failure in critically ill patients. The aim of this review is to update and discuss on the most recent findings about renal dopaminergic system and its role in several diseases involving the kidneys and the potential use of dopamine as a nephroprotective agent.
Core tip: Renal dopaminergic system is a local and independent natriuretic system necessary to maintain the normal balance of sodium and water, blood pressure and renal redox steady state. Different findings from experimental and clinical studies highlight the participation of renal dopamine in the pathophysiology of renal inflammation, hypertension, diabetic nephropathy and edema formation. Recent findings from experimental and clinical studies allow us to understand the complexity of this system as well as its possible contribution for future therapeutic strategies to prevent renal diseases.