Open AccessB‐Natriuretic Peptide for the Prevention of Radiocontrast‐Induced Nephropathy
Author(s) -
Kamalakannan Desikan,
Lattupalli Rakesh,
Mesiha Nancy,
Ganoff Michelle,
Steigerwalt Susan,
Provenzano Robert,
Khairullah Quresh,
Rosman Howard
Publication year - 2008
Publication title -
dialysis & transplantation
Language(s) - English
Resource type - Journals
eISSN - 1932-6920
pISSN - 0090-2934
DOI - 10.1002/dat.20218
Subject(s) - medicine , dialysis , placebo , renal function , cardiac catheterization , natriuretic peptide , incidence (geometry) , creatinine , nephropathy , cardiology , kidney disease , urology , heart failure , endocrinology , pathology , physics , alternative medicine , optics , diabetes mellitus
BACKGROUND: The hypothesis of the study was that infusion of B‐natriuretic peptide (BNP), by increasing renal vasodilatation and glomerular filtration, would reduce the incidence of radiocontrast nephropathy (RCIN) after cardiac catheterization in patients with preexisting renal insufficiency. METHODS: The study was a single‐center, prospective, randomized, double‐blind, placebo‐controlled pilot study of 50 patients. Patients with a baseline serum creatinine (SCr) > 1.5 mg/dL not on dialysis undergoing elective cardiac catheterization with visipaque (nonionic, iso‐osmolal contrast) were enrolled. Patients were randomly assigned to receive intravenous BNP or placebo infusion. RCIN was defined as SCr increase ≥ 0.5 mg/dL at 48 hours post‐contrast administration. RESULTS: There were no significant differences in baseline characteristics between the 2 groups. The incidence of RCIN was 3.8% (1 of 26) in the BNP group versus 12.5% (3 of 24) in the placebo group ( p = 0.340). None of the patients who developed RCIN required renal replacement therapy, and all their SCr values returned to baseline on posthospital follow‐up. On logistic regression only the baseline SCr was an independent predictor of RCIN. CONCLUSIONS: BNP infusion shows a nonsignificant trend of reduction in the incidence of RCIN in patients with chronic renal insufficiency undergoing elective cardiac catheterization. Further large‐scale trials are needed to determine the usefulness of BNP infusion to prevent RCIN.