論文

査読有り 国際誌
2020年1月30日

Effect of low-dose atrial natriuretic peptide in critically ill patients with acute kidney injury: a retrospective, single-center study with propensity-score matching.

BMC nephrology
  • Keita Saito
  • ,
  • Shigehiko Uchino
  • ,
  • Tomoko Fujii
  • ,
  • Shinjiro Saito
  • ,
  • Masanori Takinami
  • ,
  • Shoichi Uezono

21
1
開始ページ
31
終了ページ
31
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s12882-020-1701-7

BACKGROUND: Acute kidney injury (AKI) is a major comorbidity in critically ill patients. Low-dose atrial natriuretic peptide (ANP) has been shown to effectively prevent acute kidney injury (AKI), especially in cardiovascular surgery patients. However, its treatment effects for AKI in critically ill patients are unclear. METHODS: This single-center, retrospective, observational study included patients with AKI diagnosed within 7 days after intensive care unit (ICU) admission during the period January 2010 to December 2017. We conducted a propensity-matched analysis to estimate the treatment effect of low-dose carperitide (a recombinant human ANP) on the clinical outcomes. The primary outcome was a composite of death, renal replacement therapy dependence, or no recovery from AKI (defined as an increase of the serum creatinine level to ≥200% of baseline) at hospital discharge. RESULTS: During the study period, 4479 adult patients were admitted to the ICU. We identified 1374 eligible patients with AKI diagnosed within 7 days after ICU admission. Among these patients, 346 (25.2%) were treated with low-dose carperitide, with an average dose of 0.019 μg kg- 1 min- 1. The primary outcome occurred more often in the treatment group than in the control group (29.7% versus 23.4%, respectively; p = 0.022). After propensity score matching, characteristics of 314 patients from each group were well- balanced. Significant difference of the primary outcome, as seen with the full cohort, was no longer obtained; no benefit of carperitide was detected in the matched cohort (29.0% versus 25.2%; p = 0.281). CONCLUSIONS: Low-dose ANP showed no treatment effect in general critically ill patients who developed AKI.

リンク情報
DOI
https://doi.org/10.1186/s12882-020-1701-7
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32000705
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990464
ID情報
  • DOI : 10.1186/s12882-020-1701-7
  • PubMed ID : 32000705
  • PubMed Central 記事ID : PMC6990464

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