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  • Title: Atrial natriuretic peptide infusion improves ischemic renal failure after suprarenal abdominal aortic cross-clamping in dogs.
    Author: Mitaka C, Hirata Y, Habuka K, Narumi Y, Yokoyama K, Makita K, Imai T.
    Journal: Crit Care Med; 2003 Aug; 31(8):2205-10. PubMed ID: 12973181.
    Abstract:
    OBJECTIVE: The suprarenal abdominal aortic cross-clamping during aortic aneurysm repair causes renal dysfunction after surgery. Atrial natriuretic peptide (ANP), a hormone synthesized by the cardiac atria, induces diuresis-natriuresis and increases glomerular filtration rate. Therefore, we tested the hypothesis that prophylactic ANP infusion could limit the development of acute renal failure after aortic cross-clamping. DESIGN: Prospective, comparative, experimental study. SETTING: Laboratory at a university hospital. SUBJECTS: Twelve male beagle dogs (10-13 kg) with mechanical ventilation under pentobarbital anesthesia. INTERVENTIONS: A catheter was inserted into the femoral vein, and lactated Ringer solution (10 mL/kg/hr) was administered throughout the study period. Two groups of animals were studied: the control group (n = 6), which received saline vehicle before and after suprarenal abdominal aortic cross-clamping for 1.5 hrs; and the ANP group (n = 6), which received ANP (1 microg/kg/min) for 5 hrs, starting from 10 mins before suprarenal abdominal aortic cross-clamping until the end of procedure. MEASUREMENTS AND MAIN RESULTS: Changes in systemic and renal hemodynamics, blood gases, and renal function were measured at baseline and 1, 2, 3, 4, and 5 hrs after aortic cross-clamping. After aortic cross-clamping, urine volume, renal blood flow, and creatinine clearance significantly (p <.01) decreased, and serum creatinine concentrations significantly (p <.01) increased, but these effects were limited by continuous ANP infusion. CONCLUSIONS: The present study shows that ANP infusion preserved renal function after suprarenal abdominal aortic cross-clamping in dogs. These results justify a trial of ANP infusion in humans during aortic aneurysm repair.
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