Development of renal function test using dopamine and its utility in laboratory

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The free dopamine excreted in urine is derived from renal tubular dopamine, which is synthesized at the proximal tubules and regulates both natriuresis and diuresis. Urinary free dopamine derived from plasma dopamine is in negligible quantity. We investigated the usefulness of the urinary level of free dopamine as a marker of renal function, especially of tubular activity. We determined the correlations between the urinary level of free dopamine and a number of established markers of renal function. The urinary level of free dopamine was negatively correlated with the serum level of creatinine and the urinary levels of alpha_1-and beta_2-microglobulins. The receiver-operating characteristic (ROC) analysis indicated that urinary level of free dopamine is superior to other established renal parameters in sensitivity and specificity. In renal diseases, urinary level of free dopamine was significantly lower in patients with renal tubular dysfunction than in patients with glomerular dysfunction. Findings suggest that the urinary level of free dopamine is an index of renal function and is useful for evaluating renal impairments, especially renal tubular dysfunction.