Multicenter trial of carperitide in patients with renal dysfunction undergoing cardiovascular surgery

• Published in: General thoracic and cardiovascular surgery Vol. 60; no. 1; pp. 21 - 30
• Main Authors: Hisatomi, Kazuki, Eishi, Kiyoyuki
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.01.2012; Springer Nature B.V
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - etiology; Acute Kidney Injury - physiopathology; Acute Kidney Injury - prevention & control; Aged; Atrial Natriuretic Factor - administration & dosage; Atrial Natriuretic Factor - adverse effects; Biomarkers - blood; Cardiac Surgery; Cardiac Surgical Procedures - adverse effects; Cardiology; Cardiovascular surgery; Carperitide; Creatinine; Creatinine - blood; Creatinine clearance; Drug Administration Schedule; Female; Heart surgery; Humans; Infusions, Intravenous; Japan; Kidney - drug effects; Kidney - metabolism; Kidney - physiopathology; Kidney Diseases - blood; Kidney Diseases - drug therapy; Kidney Diseases - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patients; Prospective Studies; Renal dysfunction; Surgical Oncology; Thoracic Surgery; Time Factors; Treatment Outcome; Vascular Surgical Procedures - adverse effects; Japan; Creatinine; Carperitide; Cardiovascular surgery; Creatinine clearance; Renal dysfunction
• ISSN: 1863-6705; 1863-6713; 1863-6713
• DOI: 10.1007/s11748-011-0846-5

Purpose The aim of this study was to evaluate the efficacy of carperitide in maintaining renal function during intraoperative and postoperative management of patients with renal dysfunction undergoing elective cardiovascular surgery. Methods The subjects were 88 patients with a preoperative serum creatinine level ≥1.2 mg/dl who underwent elective cardiovascular surgery using cardiopulmonary bypass. They were prospectively divided into a group that received carperitide from the start of surgery (carperitide group, n = 44) and a group that was not given carperitide (control group, n = 44). Carperitide infusion was initiated at the beginning of surgery and was continued for ≥5 days, with the central dose being 0.02 g/kg/min. The primary endpoint was the serum creatinine level on postoperative day (POD) 3. Results The serum creatinine levels on PODs 3, 4, and 7 were significantly lower, and creatinine clearance on PODs 2 and 3 was significantly higher in the carperitide group than in the controls. One patient in the control group and no patient in the carperitide group required continuous hemodiafiltration, but the difference was not statistically significant. Conclusion Continuous low-dose infusion of carperitide from the start of cardiovascular surgery maintained renal function in patients with preoperative renal dysfunction.