Renal Hemodynamic Response to Vasopressor Agents in the Treatment of Shock

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Abstract
Norepinephrine, when administered to normotensive subjects by continuous intravenous infusion produces a marked renal vasoconstriction and a reduction in renal blood flow. The opposite response is observed when this drug is given to patients in whom glomerular filtration rate and renal blood flow are already depressed due to shock. When the blood pressure in these patients is returned to normal with norepinephrine, there is an increase in both glomerular filtration rate and renal blood flow. There is also an increase in water and electrolyte excretion which is secondary to the increase in glomerular filtration rate.