title: Early results of human atrial natriuretic peptide infusion in non-dialysis patients with chronic kidney disease undergoing isolated coronary artery bypass grafting: the NU-HIT trial for CKD-II.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is an important risk factor for cardiac surgery. In the most recently reported NU-HIT trial for CKD with CKD patients underwent coronary artery bypass grafting (CABG) as subjects, carperitide was reported to be effective in terms of renal function. In the present study, a subanalysis was performed on patients registered in the NU-HIT trial for CKD from the standpoint of renin-angiotensin system, natriuresis and renal function.
  
  
  METHODS
  303 patients with CKD who underwent isolated CABG were divided into a group that received carperitide infusion and another group without carperitide. The renin activity, angiotensin-II, aldosterone, urine-sodium, urine- creatinine, fractional sodium excretion, renal failure index, and BNP levels.
  
  
  RESULTS
  There were significant lower in hANP group than the placebo group, in angiotensin-II at one day postoperatively, and in aldosterone from 0 day to one month postoperatively. FENa was significantly lower in the hANP group at 3 day and one week postoperatively.
  
  
  CONCLUSIONS
  In on pump isolated CABG patients with CKD, carperitide showed a potent natriuretic action and inhibited the renin-angiotensin system, suggesting that it prevented deterioration of postoperative renal function. Our findings raise new possibilities for the perioperative and postoperative management of patients undergoing surgery with cardiopulmonary bypass.
authors.affiliation: The Department of Cardiovascular Surgery, Nihon University School of Medicine.
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Kin-ichi
authors.initials: K
authors.lastname: Nakata
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Iida
authors.forename: Isamu
authors.initials: I
authors.lastname: Yoshitake
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hata
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
mesh_terms: D009320:Atrial Natriuretic Factor / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004311:Double-Blind Method; D006801:Humans; D007263:Infusions, Parenteral; D007564:Japan; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D009318:Natriuresis / Q000187:drug effects; D012076:Renal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C472955:NPPA protein, human; D012076:Renal Agents; D009320:Atrial Natriuretic Factor