Key result
Intravenous recombinant human brain natriuretic peptide was associated with a stronger decreasing trend in postoperative serum creatinine levels (0.04 vs -0.16, P=0.001) and higher urine volume.
Why the study?
The treatment effects of recombinant human brain natriuretic peptide (rh-BNP) for acute kidney injury in patients undergoing cardiac surgery are unclear.
Does intravenous recombinant human brain natriuretic peptide improve serum creatinine levels and urine volume in patients with acute kidney injury after coronary artery bypass grafting?
Cohort (n=395)
Does intravenous recombinant human brain natriuretic peptide improve serum creatinine levels and urine volume in patients with acute kidney injury after coronary artery bypass grafting?
Answers are grounded in this paper and cite their sources.
Intravenous recombinant human brain natriuretic peptide may improve renal function by reducing serum creatinine and increasing urine volume in patients developing acute kidney injury after coronary artery bypass grafting.
Background: Acute kidney injury (AKI) is a common complication of coronary artery bypass grafting (CABG) that results in worse prognosis. Studies have shown that recombinant human brain natriuretic peptide (rh-BNP) reduces renal injury. However, its treatment effects for AKI in patients underwent cardiac surgery are unclear. This study sought to explore the efficacy of rh-BNP in patients with AKI after bypass surgery. Methods: This study included patients with AKI diagnosed within 4 days after CABG during the period January 2016 to December 2020. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The clinical characteristics and outcomes were collected. Patients were divided into BNP and non-BNP groups according to whether rh-BNP was injected intravenously after the operation. Multivariable logistic regression was adjusted the confounding effects between clinical characteristics and rh-BNP. Propensity score matching (PSM) was used to perform a sensitivity analysis. Results: A total of 395 patients, including 56 and 339 patients in the BNP and non-BNP groups, respectively, were included in this study. The decreasing trend of postoperative serum creatinine levels (P<0.001) and postoperative urine volume (P=0.001) within 4 days of surgery were independent associated with rh-BNP. From PSM, 175 patients, including 44 and 131 patients in the BNP and non-BNP groups, respectively, were included in this study. The decreasing trend of postoperative serum creatinine levels in the BNP group was significantly stronger than that in the non-BNP group (0.04±0.28 vs. −0.16±0.36, P=0.001). The postoperative urine volume within 4 days of surgery of the BNP group was higher than that of the non-BNP group (11.3±2.8 vs. 9.11±2.66, P<0.001). The cumulative dosage of diuretics after the procedure did not differ between the BNP and non-BNP groups {60 [40, 80] vs. 60 [40, 120], P=0.852}. Conclusions: Rh-BNP can reduce creatinine levels and increases postoperative urine volume to improve renal function in patients.
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Wang et al. (2022) conducted a cohort in Acute kidney injury after coronary artery bypass grafting (n=395). Recombinant human brain natriuretic peptide (rh-BNP) vs. No rh-BNP was evaluated on Decreasing trend of postoperative serum creatinine levels (p=0.001). Intravenous recombinant human brain natriuretic peptide was associated with a stronger decreasing trend in postoperative serum creatinine levels (0.04 vs -0.16, P=0.001) and higher urine volume.
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