Effects of continuous venovenous hemofiltration on the pharmacology of carperitide, a recombinant human atrial natriuretic peptide.
BACKGROUND
Natriuretic peptides exert vasodilatory, natriuretic, and diuretic effects and inhibit renin and aldosterone secretion. Carperitide, a recombinant alpha-human atrial natriuretic peptide (hANP), is used for the treatment of cardiac failure. Patients with renal failure often require renal replacement therapy, and little is known about the pharmacokinetics of carperitide when used for renal replacement therapy.


RESULTS
Eleven patients who received continuous carperitide infusion and needed continuous venovenous hemofiltration (CVVHF) for acute renal failure were observed. The plasma hANP concentration was noted and the hANP clearance during CVVHF was calculated. The results indicated that infused hANP was removed by CVVHF. Although the clearance of hANP by CVVHF was relatively lower than the expected whole body clearance, CVVHF slightly reduced plasma hANP and cyclic guanosine monophosphate concentrations and increased arterial pressure.


CONCLUSIONS
CVVHF affects the pharmacology of infused hANP in critically ill patients. Some caution with respect to blood pressure may be necessary when carrying out CVVHF for critically ill patients receiving continuous infusion of natriuretic peptides.
Takahashi
Ryoko
R
Department of Clinical Quality Management, Osaka University Hospital, Suita, Japan.
Uchiyama
Akinori
A
Iguchi
Naoya
N
Mashimo
Takashi
T
Fujino
Yuji
Y
D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001794:Blood Pressure; D006152:Cyclic GMP; D006333:Heart Failure / Q000188:drug therapy*; D006440:Hemofiltration; D006801:Humans; D008875:Middle Aged; D011994:Recombinant Proteins
C472955:NPPA protein, human; D011994:Recombinant Proteins; D009320:Atrial Natriuretic Factor; D006152:Cyclic GMP