Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II
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- Sezai Akira
- The Department of Cardiovascular Surgery, Nihon University School of Medicine
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- Nakata Kin-ichi
- The Department of Cardiovascular Surgery, Nihon University School of Medicine
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- Iida Mitsuru
- The Department of Cardiovascular Surgery, Nihon University School of Medicine
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- Yoshitake Isamu
- The Department of Cardiovascular Surgery, Nihon University School of Medicine
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- Wakui Shinji
- The Department of Cardiovascular Surgery, Nihon University School of Medicine
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- Hata Hiroaki
- The Department of Cardiovascular Surgery, Nihon University School of Medicine
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- Shiono Motomi
- The Department of Cardiovascular Surgery, Nihon University School of Medicine
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Background: Chronic kidney disease (CKD) is an important risk factor for cardiac surgery. In the most recently reported NU-HIT trial for CKD with CKD patients underwent coronary artery bypass grafting (CABG) as subjects, carperitide was reported to be effective in terms of renal function. In the present study, a subanalysis was performed on patients registered in the NU-HIT trial for CKD from the standpoint of renin-angiotensin system, natriuresis and renal function.<br>Methods: 303 patients with CKD who underwent isolated CABG were divided into a group that received carperitide infusion and another group without carperitide. The renin activity, angiotensin-II, aldosterone, urine-sodium, urine- creatinine, fractional sodium excretion, renal failure index, and BNP levels.<br>Results: There were significant lower in hANP group than the placebo group, in angiotensin-II at one day postoperatively, and in aldosterone from 0 day to one month postoperatively. FENa was significantly lower in the hANP group at 3 day and one week postoperatively.<br>Conclusions: In on pump isolated CABG patients with CKD, carperitide showed a potent natriuretic action and inhibited the renin-angiotensin system, suggesting that it prevented deterioration of postoperative renal function. Our findings raise new possibilities for the perioperative and postoperative management of patients undergoing surgery with cardiopulmonary bypass.
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 20 (3), 217-222, 2014
Annals of Thoracic and Cardiovascular Surgery 編集委員会