title: The effect of nesiritide on renal function and other clinical parameters in patients with decompensated heart failure and preserved ejection fraction.
abstract: The role of nesiritide in patients with decompensated heart failure with preserved ejection fraction (dHFpEF) has not been previously studied. In this investigation, the authors retrospectively analyzed the effect of nesiritide on renal function and clinical outcomes in patients admitted with dHFpEF. Of the 658 patients included, 328 were treated with nesiritide while 330 patients were treated with standard diuretic therapy. In both the nesiritide and no nesiritide groups, there was a significant change in mean glomerular filtration rate (GFR) and creatinine at 72 hours as well as at day of discharge (P<.001). This trend did not progress at 1 month in the nesiritide group, although it did in the no nesiritide group. At 1 month after therapy, however, there was a significant difference between the two groups in the mean change of GFR and creatinine (P<.001). There was no significant difference in >25% decrease of GFR anytime through day 30 (25% vs 29.69%, P=.236) between the two groups. On multivariate analysis, nesiritide was an important predictor of renal function at 1 month (P<.05). Thus, nesiritide can be administered safely without negatively impacting long-term renal function in patients admitted with dHFpEF.
authors.affiliation: Department of Cardiology, Albert Einstein College of Medicine, Bronx, NY 10467, USA. ikelesid@montefiore.org
authors.forename: Iosif
authors.initials: I
authors.lastname: Kelesidis
authors.forename: Jeremy
authors.initials: J
authors.lastname: Mazurek
authors.forename: Pankaj
authors.initials: P
authors.lastname: Khullar
authors.forename: Wajeeha
authors.initials: W
authors.lastname: Saeed
authors.forename: Timothy
authors.initials: T
authors.lastname: Vittorio
authors.forename: Ronald
authors.initials: R
authors.lastname: Zolty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D045283:Natriuretic Agents / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use*; D012189:Retrospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome
chemical_list: D004232:Diuretics; D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain; D003404:Creatinine