Table 1 Baseline characteristics of included studies
Trials | Patients (ANP/control) | Clinical setting (Exposure to AKI risk factors) | Purpose of administration | ANP infusion rate | ANP infusion duration | Comparator (Placebo/Control) | Outcomes |
|---|---|---|---|---|---|---|---|
Kurnik BR et al. 1998 [43] | 127/60 | contrast induced nephropathy | Prevention | 0.010 or 0.050 μg/kg/min | < 3 hrs | Placebo (5% dextrose) | Primary: maximum absolute increase in serum creatinine, maximum percent increase in serum creatinine and incidence of CIAKI Secondary: stratification on three concomitant variables: baseline serum creatinine, diabetic status risk group Others: null |
Hayashida N et al. 2000 [44] | 9/9 | mitral valve surgery | Prevention | 0.050 μg/kg/min | 6 hrs | Control | Primary: not clarified Secondary: not clarified Others: hospital mortality, length of ICU stay, occurrence of hypotension |
Hayashi Y et al. 2003 [45] | 24/26 | aneurysmectomy for abdminal aorta aneurysm | Prevention | 0.025 μg/kg/min | > 24 hrs | Control | Primary: not clarified Secondary: not clarified Others: hospital mortality, renal replacement therapy, occurrence of hypotension. |
Sward K et al. 2004 [46] | 29/30 | cardiac surgery | Treatment | 0.050 μg/kg/min | > 24 hrs | Placebo (saline) | Primary: dialysis on or before day 21 Secondary: dialysis or death on or before day 21, creatinine clearance on days 1, 2, and 3, length of ICU stay, and ICU mortality Others: null |
Sumi K et al. 2008 [47] | 30/15 | Abdominal aortic aneurysmectomy | Prevention | 0.020 or 0.050 μg/kg/min | 3 hrs | Placebo (saline) | Primary: not clarified Secondary: not clarified Others: occurrence of hypotension. |
Izumi K et al. 2008 [48] | 10/8 | cardiac surgery | Prevention | 0.020 or 0.050 μg/kg/min | > 24hrs | Control | Primary: not clarified Secondary: not clarified Others: hospital mortality, renal replacement therapy, length of ICU stay, length of hospital stay, occurrence of hypotension |
Mitaka C et al. 2008 [49] | 20/20 | abdominal aorta aneurysm repair | Prevention | 0.010-0.050 μg/kg/min | > 24hrs | Placebo | Primary: not clarified Secondary: not clarified Others: renal replacement therapy, peak serum creatinine |
Hata N et al. 2008 [50] | 26/23 | acute decompensated heart failure | Prevention | 0.010-0.050 μg/kg/min | > 24hrs | Control | Primary: not clarified Secondary: not clarified Others: occurrence of hypotension. |
Morikawa S et al. 2009 [51] | 126/128 | contrast induced nephropathy | Prevention | 0.042 μg/kg/min | > 24hrs | Placebo (Ringer solution) | Primary: a 25% increase in creatinine or an increase in creatinine of >0.5 mg/dl from baseline within 48 hr Secondary: 1) a 25% increase in creatinine within 48 hr; 2) an increase in creatinine of >0.5 mg/dl from baseline within 48 hr; 3) changes in serum creatinine, eGFR and serum cystatin C concentrations, and urinary β2-microglobulin and NAG until 1 month after the procedure; and 4) a 25% increase in creatinine or an increase in creatinine of > 0.5 mg/dl from baseline at 1 month after the procedure. Others: renal replacement therapy |
Sezai A et al. 2009 [52] | 251/253 | CABG | Prevention | 0.010-0.020 μg/kg/min | > 24hrs | Placebo (saline) | Primary: not clarified Secondary: not clarified Others: hospital mortality, renal replacement therapy, length of hospital stay, acute kidney injury (0.3mg/dl > pre-operative - maxium Cr), occurrence of hypotension, peak serum creatinine |
Sezai A et al. 2011 [53] | 141/144 | CABG | Prevention | 0.010-0.020 μg/kg/min | > 24hrs | Placebo | Primary:1) dialysis-free rate at 1 year post-operatively, 2) sCr and eGFR at 0, 1, and 3 days, 1 week, and 1 month post-operatively Secondary: 1) the early post-operative outcome (operative mortality and complications), 2) outcome at 1 year post-operatively (overall survival rate and cardiac event-free rate), 3) the maximum sCr, the rate of increase of sCr (% Cr: [maximum sCr pre-operative sCr]/pre-operative sCr Ă— 100), and an increase of sCr by 0.3 mg/dl compared with the pre-operative value, 4) ANP and cyclic-guanosine monophosphate levels (on return to intensive care unit, and on postoperative day 1, week 1, and month 1) Others: renal replacement therapy, length of ICU stay, occurrence of hypotension, peak serum creatinine |
Tamura Y et al. 2011 [54] | 19/20 | liver resection | Prevention | 0.025 μg/kg/min | 6 hrs | Control | Primary: not clarified Secondary: not clarified Others: length of ICU stay, length of hospital stay, acute kidney injury (0.3mg/dl > pre-operative - maxium Cr), peak serum creatinine |
Okumura N et al. 2012 [55] | 59/53 | contrast-induced nephropathy | Prevention | 0.013-0.025 μg/kg/min | 18-24 hrs | Placebo (Saline) | Primary: the occurrence of CIAKI Secondary: theserum creatinine and cystatin C levels Others: occurrence of hypotension |
Hisatomi K et al. 2012 [56] | 40/30 | cardiovascular surgery | Prevention | 0.010-0.020 μg/kg/min | > 24 hrs | Control | Primary: serum Cr level 3 days after surgery Secondary: serum Cr levels at each time point of measurement within 3 days after surgery Others: hospital mortality, renal replacement therapy, occurrence of hypotension. |
Wang P et al. 2013 [57] | 12/12 | acute decompensated heart failure | Prevention | 0.050 μg/kg/min | 1 hr | Control | Primary: absolute changes in PCWP from baseline to 1 hr after the start of study drug Secondary: the effect on PCWP 0.5, 3 and 12 hr after the start of study drug, the effect on CO and SV at 0.5, 1, 3 and 12 hr, patient’s self-evaluation of dyspnoea, urine volume and the overall safety profile Others: hospital mortality, occurrence of hypotension |
Mori Y et al. 2014 [58] | 20/22 | aortic arch aneurysm repair | Prevention | 0.0125 μg/kg/min | > 24 hrs | Placebo (5% glucose) | Primary: occurrence of AKI within 48hr of surgery Secondary: occurrence of dialysis and/or all-cause mortality in the first 30 postoperative days Others: length of ICU stay, length of hospital stay, occurrence of hypotension and atrial fibrillation. |
Moriyama T et al. 2017 [59] | 24/24 | cardiac surgery | Prevention | 0.025 μg/kg/min, | > 24 hrs | Placebo (5% Salie) | Primary: the occurrence of AKI Secondary: not clarified Others: occurrence of hypotension. |
Mitaka C et al. 2017 [60] | 37/40 | cardiovascular surgery | Treatment | 0.020 μg/kg/min, | > 24hrs | Placebo(5% glucose) | Primary: change in renal function over the 90-day follow up Secondary: 1) a need for renal replacement therapy over the 90-day follow-up, 2) the lengths of ICU and hospital stays, 3) medical costs incurred over the 90-day follow-up Others: occurrence of hypotension. |