Hisatomi Kazuki, Eishi Kiyoyuki
Department of Cardiovascular Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Gen Thorac Cardiovasc Surg. 2012 Jan;60(1):21-30. doi: 10.1007/s11748-011-0846-5. Epub 2012 Jan 13.
The aim of this study was to evaluate the efficacy of carperitide in maintaining renal function during intraoperative and postoperative management of patients with renal dysfunction undergoing elective cardiovascular surgery.
The subjects were 88 patients with a preoperative serum creatinine level ≥1.2 mg/dl who underwent elective cardiovascular surgery using cardiopulmonary bypass. They were prospectively divided into a group that received carperitide from the start of surgery (carperitide group, n = 44) and a group that was not given carperitide (control group, n = 44). Carperitide infusion was initiated at the beginning of surgery and was continued for ≥5 days, with the central dose being 0.02 g/kg/min. The primary endpoint was the serum creatinine level on postoperative day (POD) 3.
The serum creatinine levels on PODs 3, 4, and 7 were significantly lower, and creatinine clearance on PODs 2 and 3 was significantly higher in the carperitide group than in the controls. One patient in the control group and no patient in the carperitide group required continuous hemodiafiltration, but the difference was not statistically significant.
Continuous low-dose infusion of carperitide from the start of cardiovascular surgery maintained renal function in patients with preoperative renal dysfunction.
本研究旨在评估卡培立肽在择期心血管手术患者肾功能不全的术中及术后管理中维持肾功能的疗效。
研究对象为88例术前血清肌酐水平≥1.2mg/dl且接受体外循环择期心血管手术的患者。他们被前瞻性地分为从手术开始即接受卡培立肽治疗的组(卡培立肽组,n = 44)和未给予卡培立肽的组(对照组,n = 44)。卡培立肽在手术开始时开始输注,并持续≥5天,中心剂量为0.02μg/kg/min。主要终点是术后第3天(POD 3)的血清肌酐水平。
卡培立肽组术后第3、4和7天的血清肌酐水平显著低于对照组,术后第2和3天的肌酐清除率显著高于对照组。对照组有1例患者需要持续血液透析滤过,而卡培立肽组无患者需要,但差异无统计学意义。
从心血管手术开始持续低剂量输注卡培立肽可维持术前肾功能不全患者的肾功能。