OBJECTIVES: The purpose of this study was to determine the effect of human
atrial natriuretic peptide (hANP) in patients who underwent
coronary artery bypass grafting (
CABG) on
renal function. BACKGROUND:
Acute renal failure after
cardiac surgery is associated with high
morbidity and mortality. METHODS: A total of 504 patients who underwent
CABG were divided into 2 groups: 1 group received hANP at 0.02 microg/kg/min from the start of
cardiopulmonary bypass (hANP group), and 1 group did not receive hANP (
placebo group). Various parameters were measured before and after
surgery. RESULTS: There was no difference in mortality between the 2 groups, but post-operative complications were less frequent in the hANP group (p = 0.0208). In the hANP group,
serum creatinine (Cr) was significantly lower and
urinary Cr and Cr clearance were significantly higher from post-operative day 1 to week 1. The maximum post-operative Cr level and percent increase of Cr were significantly lower in the hANP group (p < 0.0001). Patients with Cr exceeding 2.0 mg/dl included 1 in the hANP group and 8 in the
placebo group, showing a significant difference (p = 0.0374). Four patients in the
placebo group and none in the hANP group required
hemodialysis, but the difference was not
statistically significant. CONCLUSIONS: Continuous infusion of low-dose hANP from the start of
cardiopulmonary bypass effectively maintained post-operative
renal function. Infusion of hANP prevents early post-operative
acute renal failure and helps to achieve safer
cardiac surgery. (
Clinical Trial registration number: UMIN000001440).
