Effects of intravenous low-dose recombinant human atrial natriuretic peptide on renal function in the perioperative management for gastrointestinal perforation or ileus: a retrospective single-center study.
OBJECTIVE
We studied the effectiveness of human atrial natriuretic peptide (hANP) on management of acute kidney injury.


METHODS
This retrospective single-center study included 43 patients from January 2007 to February 2010 who had undergone non-elective abdominal surgery for gastrointestinal perforation and ileus. Patients were separated into 2 groups according to whether hANP was administered or not, and 4 subgroups according to whether or not baseline serum creatinine <1.2 mg/dL; normal cre/hANP (-) (n = 22), high cre/hANP (-) (n = 10), normal cre/hANP (+) (n = 4), and high cre/hANP (+) (n = 7). The administration of hANP was started during operation.


RESULTS
The administration rate of hANP ranged between 0.02 and 0.05 μg/kg per minute, except for one patient and the average postoperative administration time of hANP was 167 ± 237 h (range, 8-888 h). There were no significant differences in characteristics of patients within four subgroups, except for patient's weight. Serum creatinine in high cre/hANP (+) got to decrease more than high cre/hANP (-). Outcomes such as 28-day mortality were not significantly different among four subgroups. No patients required renal replacement therapy in each subgroup.


CONCLUSIONS
Intravenous low dose of hANP was useful as acute kidney injury management in gastrointestinal perforation and ileus patients undergoing non-elective surgery.
Intensive Care Unit, Miyazaki Medical College, University of Miyazaki, Miyazaki, Japan. mmctm2@yahoo.co.jp
Toyoaki
T
Maruta
Go
G
Otao
Takeshi
T
Miyazato
Nozomi
N
Maruta
Koichiro
K
Yamauchi
Takao
T
Yano
Taro
T
Kawano
Isao
I
Tsuneyoshi
D058186:Acute Kidney Injury / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage* / Q000627:therapeutic use; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D045823:Ileus / Q000601:surgery*; D007416:Intestinal Perforation / Q000601:surgery*; D007677:Kidney Function Tests; D008297:Male; D019990:Perioperative Care / Q000379:methods*; D011994:Recombinant Proteins; D012189:Retrospective Studies
D011994:Recombinant Proteins; D009320:Atrial Natriuretic Factor; D003404:Creatinine