• Toyoaki Maruta, Go Otao, Takeshi Miyazato, Nozomi Maruta, Koichiro Yamauchi, Takao Yano, Taro Kawano, and Isao Tsuneyoshi.
• Intensive Care Unit, Miyazaki Medical College, University of Miyazaki, Miyazaki, Japan. mmctm2@yahoo.co.jp
• J Crit Care. 2013 Apr 1;28(2):133-40.

PurposeWe studied the effectiveness of human atrial natriuretic peptide (hANP) on management of acute kidney injury.MethodsThis retrospective single-center study included 43 patients from January 2007 to February 2010 who had undergone non-elective abdominal surgery for gastrointestinal perforation and ileus. Patients were separated into 2 groups according to whether hANP was administered or not, and 4 subgroups according to whether or not baseline serum creatinine <1.2 mg/dL; normal cre/hANP (-) (n = 22), high cre/hANP (-) (n = 10), normal cre/hANP (+) (n = 4), and high cre/hANP (+) (n = 7). The administration of hANP was started during operation.ResultsThe administration rate of hANP ranged between 0.02 and 0.05 μg/kg per minute, except for one patient and the average postoperative administration time of hANP was 167 ± 237 h (range, 8-888 h). There were no significant differences in characteristics of patients within four subgroups, except for patient's weight. Serum creatinine in high cre/hANP (+) got to decrease more than high cre/hANP (-). Outcomes such as 28-day mortality were not significantly different among four subgroups. No patients required renal replacement therapy in each subgroup.ConclusionIntravenous low dose of hANP was useful as acute kidney injury management in gastrointestinal perforation and ileus patients undergoing non-elective surgery.Copyright © 2013 Elsevier Inc. All rights reserved.

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