Impact of nesiritide on renal function and mortality in patients suffering from heart failure.
BACKGROUND
Acutely decompensated congestive heart failure is a major public health problem, with constantly rising prevalence, morbidity, mortality and need for hospitalization in both America and Europe. In 2001, the FDA approved the use of the drug nesiritide, which is a recombinant form of human brain or B-type natriuretic peptide (BNP) for the treatment of acutely decompensated congestive heart failure. In 2005, suspicions arose that nesiritide may worsen renal function and increase the risk of short term mortality when given to patients with acutely decompensated heart failure.


METHODS
The present study reviews the recent literature with respect to the risk of deterioration in renal function and survival after the use of nesiritide in these patients.


RESULTS
Administration of nesiritide may be considered for the treatment of heart failure and especially in patients with dyspnea at rest or with minimal activity.


CONCLUSIONS
Extreme caution is required when using nesiritide in patients with both heart failure and concurrent morbidities such as renal dysfunction.
Dontas
Ioannis D
ID
Department of Experimental Surgery and Surgical Research N.S.Christeas, University of Athens, Medical School, Athens, Greece.
Xanthos
Theodoros
T
Dontas
Ismene
I
Lelovas
Pavlos
P
Papadimitriou
Lila
L
D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D004417:Dyspnea / Q000188:drug therapy; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D045283:Natriuretic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000009:adverse effects* / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000139:chemically induced / Q000150:complications / Q000401:mortality; D016019:Survival Analysis
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain; D003404:Creatinine