title: Influence of continuous infusion of low-dose human atrial natriuretic peptide on renal function during cardiac surgery: a randomized controlled study.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of human atrial natriuretic peptide (hANP) in patients who underwent coronary artery bypass grafting (CABG) on renal function.
  
  
  BACKGROUND
  Acute renal failure after cardiac surgery is associated with high morbidity and mortality.
  
  
  METHODS
  A total of 504 patients who underwent CABG were divided into 2 groups: 1 group received hANP at 0.02 microg/kg/min from the start of cardiopulmonary bypass (hANP group), and 1 group did not receive hANP (placebo group). Various parameters were measured before and after surgery.
  
  
  RESULTS
  There was no difference in mortality between the 2 groups, but post-operative complications were less frequent in the hANP group (p = 0.0208). In the hANP group, serum creatinine (Cr) was significantly lower and urinary Cr and Cr clearance were significantly higher from post-operative day 1 to week 1. The maximum post-operative Cr level and percent increase of Cr were significantly lower in the hANP group (p < 0.0001). Patients with Cr exceeding 2.0 mg/dl included 1 in the hANP group and 8 in the placebo group, showing a significant difference (p = 0.0374). Four patients in the placebo group and none in the hANP group required hemodialysis, but the difference was not statistically significant.
  
  
  CONCLUSIONS
  Continuous infusion of low-dose hANP from the start of cardiopulmonary bypass effectively maintained post-operative renal function. Infusion of hANP prevents early post-operative acute renal failure and helps to achieve safer cardiac surgery. (
  
  
  BACKGROUND
  UMIN000001440).
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. asezai@med.nihon-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Niino
authors.forename: Isamu
authors.initials: I
authors.lastname: Yoshitake
authors.forename: Satoshi
authors.initials: S
authors.lastname: Unosawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Shunji
authors.initials: S
authors.lastname: Osaka
authors.forename: Tadateru
authors.initials: T
authors.lastname: Takayama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003404:Creatinine / Q000097:blood / Q000652:urine; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007430:Intraoperative Care / Q000379:methods*; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D051437:Renal Insufficiency / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D009320:Atrial Natriuretic Factor; D003404:Creatinine