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2016 ; 2016
(ä): 5985327
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gab.com Text
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English Wikipedia
Recombinant Brain Natriuretic Peptide for the Prevention of Contrast-Induced
Nephropathy in Patients with Chronic Kidney Disease Undergoing Nonemergent
Percutaneous Coronary Intervention or Coronary Angiography: A Randomized
Controlled Trial
#MMPMID26949703
Liu J
; Xie Y
; He F
; Gao Z
; Hao Y
; Zu X
; Chang L
; Li Y
Biomed Res Int
2016[]; 2016
(ä): 5985327
PMID26949703
show ga
The role of brain natriuretic peptide (BNP) in the prevention of contrast-induced
nephropathy (CIN) is unknown. This study aimed to investigate BNP's effect on CIN
in chronic kidney disease (CKD) patients undergoing elective percutaneous
coronary intervention (PCI) or coronary angiography (CAG). The patients were
randomized to BNP (0.005??g/kg/min before contrast media (CM) exposure and saline
hydration, n = 106) or saline hydration alone (n = 103). Cystatin C, serum
creatinine (SCr) levels, and estimated glomerular filtration rates (eGFR) were
assessed at several time points. The primary endpoint was CIN incidence;
secondary endpoint included changes in cystatin C, SCr, and eGFR. CIN incidence
was significantly lower in the BNP group compared to controls (6.6% versus 16.5%,
P = 0.025). In addition, a more significant deterioration of eGFR, cystatin C,
and SCr from 48?h to 1 week (P < 0.05) was observed in controls compared to the
BNP group. Although eGFR gradually deteriorated in both groups, a faster recovery
was achieved in the BNP group. Multivariate logistic regression revealed that
using >100?mL of CM (odds ratio: 4.36, P = 0.004) and BNP administration (odds
ratio: 0.21, P = 0.006) were independently associated with CIN. Combined with
hydration, exogenous BNP administration before CM effectively decreases CIN
incidence in CKD patients.