Key result
Low-dose hANP infusion preserves renal function vs. placebo, improving creatinine and clearance.
Why the study?
Ischemia-reperfusion injury is an important cause of renal dysfunction after abdominal aortic aneurysm repair, and the effects of human atrial natriuretic peptide on renal function in these patients required evaluation.
Does continuous infusion of human atrial natriuretic peptide preserve renal function in patients undergoing elective abdominal aortic aneurysm repair?
RCT (n=40)
Placebo-controlled
Randomized
No
Does continuous infusion of human atrial natriuretic peptide preserve renal function in patients undergoing elective abdominal aortic aneurysm repair?
Intraoperative and postoperative infusion of low-dose human atrial natriuretic peptide preserves renal function in patients undergoing abdominal aortic aneurysm repair.
Answers are grounded in this paper and cite their sources.
Supports hANP infusion for renal preservation in elective AAA repair; extends evidence for natriuretic peptides in high-risk vascular surgery.
Objective Ischemia-reperfusion injury is an important cause of renal dysfunction after abdominal aortic aneurysm repair. Human atrial natriuretic peptide (hANP) is a potent endogenous natriuretic, diuretic, and vasorelaxant peptide. The objective of the present study was to evaluate the effects of hANP on renal function in patients undergoing abdominal aortic aneurysm repair. Design A prospective, randomized, placebo-controlled study Setting Intensive care unit of a university hospital. Patients Forty patients undergoing elective abdominal aortic aneurysm repair. Interventions The patients were randomized to receive a continuous infusion of either hANP (0.01-0.05 microg/kg/min) (n = 20) or placebo (n = 20) immediately before aortic cross-clamping. The infusion of hANP or placebo continued for 48 hrs. Measurements and main results Blood and urine samples were taken before surgery, at admission to the intensive care unit, and on days 1, 2, and 3 postoperatively, for measurement of serum concentrations of sodium, creatinine, and blood urea nitrogen and plasma concentrations of ANP and brain natriuretic peptide (BNP). Urine volume and urinary concentrations of N-acetyl-beta-D-glucosaminidase (NAG), sodium, and creatinine were also measured. The mean plasma concentration of ANP was significantly higher in the hANP group than in the placebo group. The mean plasma BNP concentration was significantly lower in the hANP group than in the placebo group. The mean serum concentrations of creatinine and blood urea nitrogen were significantly (p < .05) lower in the hANP group than in the placebo group. The mean urine volume and mean creatinine clearance were significantly (p < .05) higher in the hANP group than in the placebo group. The mean urinary NAG/creatinine ratio was significantly (p < .05) lower in the hANP group than in the placebo group. Conclusions The intraoperative and postoperative infusion of low-dose hANP preserved renal function in patients undergoing abdominal aortic aneurysm repair. Further studies are needed to assess the efficacy of prophylactic hANP infusion on perioperative renal outcome.
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Mitaka et al. (2008) conducted an RCT in Abdominal aortic aneurysm undergoing elective repair (n=40). Human atrial natriuretic peptide (hANP) vs. Placebo was evaluated on Renal function parameters (serum creatinine, blood urea nitrogen, urine volume, creatinine clearance, and urinary NAG/creatinine ratio) (p=<0.05). Low-dose hANP infusion for 48 hours preserved renal function compared with placebo, lowering serum creatinine and BUN and increasing creatinine clearance.
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