Abstract
Objectives: Acute kidney injury (AKI) following cardiovascular surgery is common and is associated with both morbidity and mortality. In this study, we evaluated the effects of atrial natriuretic peptide (ANP, carperitide) on hemodynamics and renal function in patients undergoing cardiovascular surgery. Methods: The PubMed database and the references from identified articles were used to perform a literature search on the cardiovascular and renal effects of ANP in patients undergoing cardiovascular surgery. Results: Eleven randomized controlled studies presented data on ANP infusion in patients undergoing cardiovascular surgery. Most of the studies had a small sample size and were from a single center. ANP infusion increased the urine output and creatinine clearance or the glomerular filtration rate (GFR), reduced the use of diuretics, and reduced the serum creatinine and blood urea nitrogen (BUN) levels, compared with a Control group. Only 3 studies mentioned the incidence of hemodialysis and mortality. This combined data was insufficient to determine the effect of ANP infusion during the perioperative period on long-term outcome in patients undergoing cardiovascular surgery. Conclusions: ANP infusion preserved postoperative renal function in patients undergoing cardiovascular surgery. However, few studies have examined the incidence of hemodialysis, the length of hospital stay, mortality, and the associated medical costs. Therefore, a large, multicenter, randomized controlled study is needed to assess the effect of ANP on renal function, the length of hospital stay, outcomes, and medical costs in these patients.
