Carperitide Increases the Need for Renal Replacement Therapy After Cardiovascular Surgery

J Cardiothorac Vasc Anesth. 2015 Dec;29(6):1426-31. doi: 10.1053/j.jvca.2015.04.022. Epub 2015 Apr 28.

Abstract

Objectives: Acute kidney injury is a common complication after aortic surgery. Carperitide, a human atrial natriuretic peptide, was reported to be effective for preventing acute kidney injury after cardiac surgery. However, most studies were from single centers, and results of meta-analyses are subject to publication bias. The aim of the present study was to investigate whether carperitide preserved renal function in patients undergoing cardiovascular surgery.

Design: Retrospective cohort study.

Setting: Participating hospitals (N = 281) in a national database from 2010 to 2013.

Participants: Adult patients (N = 47,032) who underwent cardiovascular surgery.

Interventions: None.

Measurements and main results: The main intervention variable investigated was the use of carperitide on the day of surgery. Assessed outcomes included receiving renal replacement therapy within 21 days of surgery and in-hospital mortality. Data were available for 47,032 patients, of whom 2,186 (4.6%) received carperitide on the day of surgery. Multivariate logistic regression analysis revealed that carperitide was significantly associated with a greater likelihood of receiving renal replacement therapy within 21 days of surgery, but not with in-hospital mortality.

Conclusions: In patients undergoing cardiovascular surgery, carperitide significantly increased the odds of receiving renal replacement therapy within 21 days after surgery.

Keywords: atrial natriuetic peptide; cardiovascular surgery; carperitide; mortality; perioperative care; renal failure; renal replacement therapy.

MeSH terms

  • Aged
  • Aortic Aneurysm, Thoracic / drug therapy*
  • Aortic Aneurysm, Thoracic / surgery*
  • Atrial Natriuretic Factor / adverse effects*
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / trends*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / chemically induced*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / therapy
  • Renal Replacement Therapy / trends*
  • Retrospective Studies

Substances

  • NPPA protein, human
  • Atrial Natriuretic Factor