Effects of low-dose atrial natriuretic peptide infusion on cardiac surgery–associated acute kidney injury: A multicenter randomized controlled trial

Autor: Takanori Murayama, Michio Nagashima, Makoto Tomita, Naoya Iguchi, Tetsu Ohnuma, Fumio Kunimoto, Chieko Mitaka, Tetsuhiro Takei
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Renal function
030204 cardiovascular system & hematology
Kidney Function Tests
Critical Care and Intensive Care Medicine
Placebo
law.invention
03 medical and health sciences
chemistry.chemical_compound
Postoperative Complications
0302 clinical medicine
Double-Blind Method
Japan
Randomized controlled trial
Atrial natriuretic peptide
law
Internal medicine
medicine
Humans
Prospective Studies
030212 general & internal medicine
Renal replacement therapy
Cardiac Surgical Procedures
Infusions
Intravenous
Aged
Creatinine
business.industry
Acute kidney injury
Health Care Costs
Acute Kidney Injury
Length of Stay
medicine.disease
Intensive care unit
Renal Replacement Therapy
Intensive Care Units
chemistry
Anesthesia
Cardiology
Female
business
Atrial Natriuretic Factor
Zdroj: Journal of Critical Care. 38:253-258
ISSN: 0883-9441
Popis: Purpose To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. Materials and methods The J apanese trial for A KI in P ost-cardiovascular surgery patients by AN P (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0.3 mg/dL within 48 hours. The patients were randomly assigned to receive ANP (0.02 μg kg −1 min −1 ) or placebo. The primary end point was a change in renal function. The secondary end points were a need for renal replacement therapy, the lengths of intensive care unit and hospital stays, and medical costs incurred over the 90-day follow-up. Results Of the 77 randomized patients, 37 were in the ANP group and 40 were in the placebo group. Although ANP significantly ( P = .018) increased urine output, it did not significantly improve renal function compared with placebo. There were no significant differences between the groups in the renal replacement therapy rate, the lengths of the intensive care unit and hospital stays, or medical costs. Conclusion Atrial natriuretic peptide infusion did not show a renoprotective effect or cost-saving effect in the treatment of cardiac surgery–associated AKI.
Databáze: OpenAIRE
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