title: Effects of low-dose atrial natriuretic peptide infusion on cardiac surgery-associated acute kidney injury: A multicenter randomized controlled trial.
abstract: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery.
  
  
  
  The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0.3 mg/dL within 48 hours. The patients were randomly assigned to receive ANP (0.02 μg kg-1min-1) or placebo. The primary end point was a change in renal function. The secondary end points were a need for renal replacement therapy, the lengths of intensive care unit and hospital stays, and medical costs incurred over the 90-day follow-up.
  
  
  
  Of the 77 randomized patients, 37 were in the ANP group and 40 were in the placebo group. Although ANP significantly (P = .018) increased urine output, it did not significantly improve renal function compared with placebo. There were no significant differences between the groups in the renal replacement therapy rate, the lengths of the intensive care unit and hospital stays, or medical costs.
  
  
  
  Atrial natriuretic peptide infusion did not show a renoprotective effect or cost-saving effect in the treatment of cardiac surgery-associated AKI.
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Department of Anesthesiology and Pain Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan,. Electronic address: c.mitaka.icu@tmd.ac.jp.
authors.forename: Chieko
authors.initials: C
authors.lastname: Mitaka
authors.affiliation: Intensive Care Unit, Department of Anesthesiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Ohmiya-ku, Saitama 330-8503, Japan. Electronic address: tetsu.fe3@gmail.com.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Ohnuma
authors.affiliation: Intensive Care Unit, Department of Anesthesiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Ohmiya-ku, Saitama 330-8503, Japan. Electronic address: takanori@omiya.jichi.ac.jp.
authors.forename: Takanori
authors.initials: T
authors.lastname: Murayama
authors.affiliation: Intensive Care Unit, Gunma University Hospital, 3-39-15 Shouwa, Maebashi, Gunma 371-8511, Japan. Electronic address: kunimoto@gunma-u.ac.jp.
authors.forename: Fumio
authors.initials: F
authors.lastname: Kunimoto
authors.affiliation: Intensive Care Unit, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama, Kanagawa 231-8682, Japan. Electronic address: nagamic00@gmail.com.
authors.forename: Michio
authors.initials: M
authors.lastname: Nagashima
authors.affiliation: Intensive Care Unit, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama, Kanagawa 231-8682, Japan. Electronic address: takei.icu@yokohama.jrc.or.jp.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Takei
authors.affiliation: Intensive Care Unit, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: iguchi@hp-icu.med.osaka-u.ac.jp.
authors.forename: Naoya
authors.initials: N
authors.lastname: Iguchi
authors.affiliation: Clinical Research Center, Tokyo Medical and Dental University Hospital of Medicine 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: tomita.crc@tmd.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Tomita
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy*; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures; D004311:Double-Blind Method; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D007564:Japan; D007677:Kidney Function Tests; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data
chemical_list: D009320:Atrial Natriuretic Factor
keywords: Acute kidney injury; Atrial natriuretic peptide; Cardiac surgery; Medical costs; Renal function