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Dopamine is an endogenous catecholamine with an important role in the regulation of renal function, sodium homeostasis and blood pressure. D1 receptors on vascular smooth muscle mediate vasodilatation, while stimulation of D1 receptors in the renal proximal tubules leads to natriuresis and diuresis. D2 receptors on presynaptic sympathetic nerve endings inhibit noradrenaline release. Dopamine infusions are used widely for the management of cardiovascular disorders and renal dysfunction in intensive care units. The ability of dopamine to `protect’ the kidney against ischaemic or toxic insults requires proper evaluation in controlled trials. A number of dopaminergic prodrugs, selective dopamine agonists and dopamine congeners with additional actions on other adrenoceptors have been developed. These drugs are undergoing clinical trials in the management of cardiovascular disorders such as hypertension, heart failure and shock.
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