Carperitide Increases the Need for Renal Replacement Therapy After Cardiovascular Surgery.
OBJECTIVE
Acute kidney injury is a common complication after aortic surgery. Carperitide, a human atrial natriuretic peptide, was reported to be effective for preventing acute kidney injury after cardiac surgery. However, most studies were from single centers, and results of meta-analyses are subject to publication bias. The aim of the present study was to investigate whether carperitide preserved renal function in patients undergoing cardiovascular surgery.


METHODS
Retrospective cohort study.


METHODS
Participating hospitals (N = 281) in a national database from 2010 to 2013.


METHODS
Adult patients (N = 47,032) who underwent cardiovascular surgery.


METHODS
None.


RESULTS
The main intervention variable investigated was the use of carperitide on the day of surgery. Assessed outcomes included receiving renal replacement therapy within 21 days of surgery and in-hospital mortality. Data were available for 47,032 patients, of whom 2,186 (4.6%) received carperitide on the day of surgery. Multivariate logistic regression analysis revealed that carperitide was significantly associated with a greater likelihood of receiving renal replacement therapy within 21 days of surgery, but not with in-hospital mortality.


CONCLUSIONS
In patients undergoing cardiovascular surgery, carperitide significantly increased the odds of receiving renal replacement therapy within 21 days after surgery.
Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan; Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan. Electronic address: sasabuchi-tky@umin.ac.jp.
Yusuke
Y
Sasabuchi
Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.
Hideo
H
Yasunaga
Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.
Hiroki
H
Matsui
Department of Surgery, Jichi Medical University, Tochigi, Japan.
Alan K
AK
Lefor
Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
Kiyohide
K
Fushimi
Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Masamitsu
M
Sanui
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000188:drug therapy* / Q000601:surgery*; D009320:Atrial Natriuretic Factor / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D017582:Renal Replacement Therapy / Q000639:trends*; D012189:Retrospective Studies
C472955:NPPA protein, human; D009320:Atrial Natriuretic Factor
atrial natriuetic peptide; cardiovascular surgery; carperitide; mortality; perioperative care; renal failure; renal replacement therapy