Brain Natriuretic Peptide for Prevention of Contrast-Induced Nephropathy After Percutaneous Coronary Intervention or Coronary Angiography |
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| Institution: | 1. Department of Materials Science and Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan;2. Institute of Industrial Safety and Disaster Prevention, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan;3. Department of Environment Engineering and Science, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan;4. Nature and Science Group, Hunei Jr. High School, Kaohsiung 82942, Taiwan;1. Graduate School of Agriculture, Hokkaido University, Sapporo 060-8589, Japan;2. Research Faculty of Agriculture, Hokkaido University, Sapporo 060-8589, Japan;1. Kazan Institute of Biochemistry and Biophysics, Kazan Scientific Center, Russian Academy of Sciences, Kazan, Russia;2. Belozersky Institute of Physico-Chemical Biology of Lomonosov Moscow State University, Moscow, Russia;1. College of Chemistry and Chemical Engineering, Chemical Synthesis and Pollution Control Key Laboratory of Sichuan Province, China West Normal University, Nanchong 637002, PR China;2. College of Chemistry, Key Laboratory of Green Chemistry and Technology in Ministry of Education, Sichuan University, Chengdu 610064, PR China;1. State Key Laboratory of Microbial Technology, School of Life Science, Shandong University, Jinan, People’s Republic of China;2. Institute of Basic Medicine, Shandong Academy of Medical Science, Jinan, People’s Republic of China;3. Environment Research Institute, Shandong University, Jinan 250100, People’s Republic of China |
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| Abstract: | BackgroundMany methods reportedly prevent contrast-induced nephropathy (CIN), but the effect of brain natriuretic peptide (BNP) on CIN is unknown. In this study we investigated recombinant BNP use before coronary angiography (CA) or nonemergent percutaneous coronary intervention (PCI) in patients with unstable angina.MethodsOne thousand patients with unstable angina were prospectively evaluated. The patients were randomly assigned to: group A, isotonic normal saline (NaCl 0.9%, 1 mL/kg/h) for 24 hours before CA or PCI; and group B, human recombinant BNP (rhBNP; 0.005 μg/kg/min). Serum creatinine (Scr) levels and estimated glomerular filtration rate were measured before and 24, 48, and 72 hours, and 7 days after the procedure. The primary outcome was CIN incidence defined according to a relative (≥ 25%) or absolute (≥ 0.5 mg/dL and 44 μmol/L, respectively) increase in Scr from baseline within 48 hours. The secondary end points were the changes in the Scr and estimated glomerular filtration rate, before and after the procedure.ResultsContrast volume, a history of diabetes mellitus, and BNP administration independently predicted CIN. The incidence of CIN was significantly greater in group A than in group B (14.8% vs 5.6%; P < 0.01). Renal function was less compromised in patients who received rhBNP. The Scr of all patients with CIN remained increased for 24 hours, but it was lower and recovered faster in patients who received rhBNP.ConclusionsrhBNP administration before CA or PCI protects renal function and can significantly decrease CIN incidence. |
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