Urodilatin: a new peptide with beneficial effects in the postoperative therapy of cardiac transplant recipients.
Renal failure after heart transplantation (HTx) still remains a serious problem, especially when cyclosporin A is used for immunosuppression in the early postoperative therapy. To preserve good renal function without reducing immunosuppressive cyclosporin A treatment, we administered urodilatin (CDD/ANP-95-126) in a long-term, low-dose infusion in addition to the usual medication after heart transplantation. From November 1990 to June 1991, 51 patients (46 male and 5 female; mean age 48 years) were treated with a 6-20 ng/kg bw.min infusion for 96 h after HTx. The renal function and hemodynamic parameters of these urodilatin-treated patients were compared in this sequential study with 40 patients (33 male and 7 female; mean age 49 years) who had undergone HTx previously from May to November, 1990, as controls. In this phase IIa study, both groups did not differ significantly with respect to age, sex, indication for HTx, and preoperative renal function. In comparison with controls patients treated with urodilatin had a significantly better renal function: a reduction in the peak plasma creatinine (PC values day 4: 1.5 +/- 0.11 vs. 2.19 +/- 0.19 mg/dl; P = 0.002), a lower peak serum urea (SU values day 4: 109 +/- 8 vs. 154.7 +/- 8.94 mg/dl; P = 0.0036), and a lower incidence of hemodialysis (6% vs. 10%) were observed. Adequate diuresis was maintained in spite of the reduction of furosemide by more than 60% (P = 0.005) on each day of urodilatin infusion in comparison with controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Hummel
M
M
Deutsches Herzzentrum Berlin.
Kuhn
M
M
Bub
A
A
Bittner
H
H
Kleefeld
D
D
Marxen
P
P
Schneider
B
B
Hetzer
R
R
Forssmann
W G
WG
D058186:Acute Kidney Injury / Q000517:prevention & control*; D000328:Adult; D009320:Atrial Natriuretic Factor / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000627:therapeutic use; D010446:Peptide Fragments / Q000627:therapeutic use*; D011182:Postoperative Care / Q000379:methods*; D006435:Renal Dialysis
D002395:Catecholamines; D004232:Diuretics; D010446:Peptide Fragments; C056452:Ularitide; D005665:Furosemide; D016572:Cyclosporine; D009320:Atrial Natriuretic Factor; D005996:Nitroglycerin