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January 21, 2004Nephrology Dialysis Transplantation62 citationsOpen Access

The efficacy and safety of B-type natriuretic peptide (nesiritide) in patients with renal insufficiency and acutely decompensated congestive heart failure

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Why the study?

Does nesiritide improve hemodynamics and dyspnea in patients with acute decompensated congestive heart failure and renal insufficiency?

Population

489 patients with acute decompensated congestive heart failure from the VMAC trial database, including a…

Comparison

Nesiritide (B-type natriuretic peptide) infusion vs Placebo added to standard therapies, and…

Design

RCT, randomized

Follow-up

24 h

Key result

Nesiritide significantly reduced pulmonary capillary wedge pressure and improved dyspnea at 24 hours in 83% of acute heart failure patients with renal insufficiency.

Authors

JBJaved Butler

Discussion

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Overview

Supports nesiritide in acute HF with renal insufficiency; extends RCT evidence to this high-risk subgroup.

Study Design

Type

RCT (n=489)

Multicenter

Yes

Structured PICO

Does nesiritide improve hemodynamics and dyspnea in patients with acute decompensated congestive heart failure and renal insufficiency?

P
Population
489 patients with acute decompensated congestive heart failure from the VMAC trial database, including a subset with renal insufficiency (SCr >= 2.0 mg/dl, n=60 treated with nesiritide) and without renal insufficiency (SCr < 2.0 mg/dl, n=209 treated with nesiritide).
I
Intervention
Nesiritide (B-type natriuretic peptide) infusion
C
Comparator
Placebo added to standard therapies, and nitroglycerin
O
Outcome
Pulmonary capillary wedge pressure (PCWP) at 3 hsurrogate

Nesiritide safely improves hemodynamics and dyspnea in patients with acute decompensated heart failure and renal insufficiency without worsening renal function.

Cite This Study

Javed Butler (2004) conducted an RCT in Acute decompensated congestive heart failure (n=489). Nesiritide vs. Placebo and Nitroglycerin was evaluated on Pulmonary capillary wedge pressure (PCWP) at 3 hours. Nesiritide significantly reduced pulmonary capillary wedge pressure and improved dyspnea at 24 hours in 83% of acute heart failure patients with renal insufficiency.

synapsesocial.com/papers/6a11c04b6229a93195178f77https://doi.org/10.1093/ndt/gfg558
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