title: Brain natriuretic peptide for prevention of contrast-induced nephropathy after percutaneous coronary intervention or coronary angiography.
abstract: BACKGROUND
  Many methods reportedly prevent contrast-induced nephropathy (CIN), but the effect of brain natriuretic peptide (BNP) on CIN is unknown. In this study we investigated recombinant BNP use before coronary angiography (CA) or nonemergent percutaneous coronary intervention (PCI) in patients with unstable angina.
  
  
  METHODS
  One thousand patients with unstable angina were prospectively evaluated. The patients were randomly assigned to: group A, isotonic normal saline (NaCl 0.9%, 1 mL/kg/h) for 24 hours before CA or PCI; and group B, human recombinant BNP (rhBNP; 0.005 μg/kg/min). Serum creatinine (Scr) levels and estimated glomerular filtration rate were measured before and 24, 48, and 72 hours, and 7 days after the procedure. The primary outcome was CIN incidence defined according to a relative (≥ 25%) or absolute (≥ 0.5 mg/dL and 44 μmol/L, respectively) increase in Scr from baseline within 48 hours. The secondary end points were the changes in the Scr and estimated glomerular filtration rate, before and after the procedure.
  
  
  RESULTS
  Contrast volume, a history of diabetes mellitus, and BNP administration independently predicted CIN. The incidence of CIN was significantly greater in group A than in group B (14.8% vs 5.6%; P < 0.01). Renal function was less compromised in patients who received rhBNP. The Scr of all patients with CIN remained increased for 24 hours, but it was lower and recovered faster in patients who received rhBNP.
  
  
  CONCLUSIONS
  rhBNP administration before CA or PCI protects renal function and can significantly decrease CIN incidence.
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Liu
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Ya-Nan
authors.initials: YN
authors.lastname: Xie
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Zi-Han
authors.initials: ZH
authors.lastname: Gao
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Xiu-Guang
authors.initials: XG
authors.lastname: Zu
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. Electronic address: Liyongjunmedsci@163.com.
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Li
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Hao
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Chang
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control*; D007677:Kidney Function Tests; D008297:Male; D045283:Natriuretic Agents / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use*; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain; D003404:Creatinine