Atrial natriuretic peptide infusion improves ischemic renal failure after suprarenal abdominal aortic cross-clamping in dogs.
OBJECTIVE
The suprarenal abdominal aortic cross-clamping during aortic aneurysm repair causes renal dysfunction after surgery. Atrial natriuretic peptide (ANP), a hormone synthesized by the cardiac atria, induces diuresis-natriuresis and increases glomerular filtration rate. Therefore, we tested the hypothesis that prophylactic ANP infusion could limit the development of acute renal failure after aortic cross-clamping.


METHODS
Prospective, comparative, experimental study.


METHODS
Laboratory at a university hospital.


METHODS
Twelve male beagle dogs (10-13 kg) with mechanical ventilation under pentobarbital anesthesia.


METHODS
A catheter was inserted into the femoral vein, and lactated Ringer solution (10 mL/kg/hr) was administered throughout the study period. Two groups of animals were studied: the control group (n = 6), which received saline vehicle before and after suprarenal abdominal aortic cross-clamping for 1.5 hrs; and the ANP group (n = 6), which received ANP (1 microg/kg/min) for 5 hrs, starting from 10 mins before suprarenal abdominal aortic cross-clamping until the end of procedure.


RESULTS
Changes in systemic and renal hemodynamics, blood gases, and renal function were measured at baseline and 1, 2, 3, 4, and 5 hrs after aortic cross-clamping. After aortic cross-clamping, urine volume, renal blood flow, and creatinine clearance significantly (p <.01) decreased, and serum creatinine concentrations significantly (p <.01) increased, but these effects were limited by continuous ANP infusion.


CONCLUSIONS
The present study shows that ANP infusion preserved renal function after suprarenal abdominal aortic cross-clamping in dogs. These results justify a trial of ANP infusion in humans during aortic aneurysm repair.
Mitaka
Chieko
C
Department of Critical Care Medicine, Tokyo Medical and Dental University Graduate School, Japan. c.mitaki.icu@tmd.ac.jp
Hirata
Yukio
Y
Habuka
Kenichiro
K
Narumi
Yutaka
Y
Yokoyama
Kuninori
K
Makita
Koshi
K
Imai
Takasuke
T
D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D000818:Animals; D001012:Aorta, Abdominal; D001014:Aortic Aneurysm / Q000601:surgery; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage* / Q000494:pharmacology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003250:Constriction; D004285:Dogs; D006439:Hemodynamics; D007262:Infusions, Intravenous; D007677:Kidney Function Tests; D008297:Male; D011446:Prospective Studies; D012079:Renal Circulation / Q000187:drug effects; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*
D009320:Atrial Natriuretic Factor