title: The efficacy of human atrial natriuretic peptide in patients with renal dysfunction undergoing cardiac surgery.
abstract: OBJECTIVE
  The purpose of this study was to investigate the efficacy of carperitide (human atrial natriuretic peptide [h-ANP]) in perioperative management in patients with renal dysfunction, especially its kidney-protecting effects.
  
  
  METHODS
  The subjects were 18 patients who underwent elective cardiac surgery using cardiopulmonary bypass (CPB) with a preoperative serum creatinine (Cr) level of 1.2 mg/dl or more. The subjects were prospectively assigned to 2 groups: an h-ANP-treated group (Group H, n = 10) and a non-h-ANP-treated group (Group N, n = 8). At the beginning of surgery, h-ANP administration was initiated and continued for 5 days or more. The central dose was 0.02 microg/kg/min. The primary end point included the serum Cr level and creatinine clearance (Ccr).
  
  
  RESULTS
  In Group H, Cr level significantly decreased after surgery compared to the preoperative level. The Ccr values were significantly higher 2 and 3 days after surgery than the preoperative values. And the intraoperative urine volume significantly increased. In Group H, an increase in urinary N-acetyl-beta-D-glucosaminidase (NAG) level the day after surgery was significantly inhibited in comparison with Group N.
  
  
  CONCLUSIONS
  The results of this study suggest that in patients with renal dysfunction before cardiac surgery, continuous low-dose h-ANP therapy maintains renal function, preventing its deterioration.
authors.affiliation: Division of Cardiovascular Surgery, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Izumi
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Eishi
authors.forename: Shiro
authors.initials: S
authors.lastname: Yamachika
authors.forename: Kouji
authors.initials: K
authors.lastname: Hashizume
authors.forename: Seiichi
authors.initials: S
authors.lastname: Tada
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamane
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takai
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Tanigawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Miura
authors.forename: Shun
authors.initials: S
authors.lastname: Nakaji
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D001806:Blood Urea Nitrogen; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003404:Creatinine / Q000097:blood; D050556:Fatty Acid-Binding Proteins / Q000652:urine; D006331:Heart Diseases / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007263:Infusions, Parenteral; D015850:Interleukin-6 / Q000097:blood; D007674:Kidney Diseases / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D019990:Perioperative Care; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014563:Urodynamics
chemical_list: D015415:Biomarkers; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; C508600:IL6 protein, human; D015850:Interleukin-6; C472955:NPPA protein, human; D014409:Tumor Necrosis Factor-alpha; D009320:Atrial Natriuretic Factor; D003404:Creatinine; D000118:Acetylglucosaminidase