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Table 1 Baseline characteristics of included studies

From: Low-dose atrial natriuretic peptide for prevention or treatment of acute kidney injury: a systematic review and meta-analysis

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 × 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.
  1. Abbreviations: AKI acute kidney injury, ANP atrial natriuretic peptide, BNP brain natriuretic peptide, CABG coronary artery bypass grafting, CIAKI contrast-induced acute kidney injury, CO cardiac output, CPK creatine kinase, Cr creatinine, EF ejection fraction, eGFR estimated glomerular filtration rate, ICU intensive care unit, NAG N-Acetyl Glucosaminidase, PCWP pulmonary capillary wedge pressure, sCr serum creatinine, SV stroke volume