Effects of intravenous low-dose recombinant human atrial natriuretic peptide on renal function in the perioperative management for gastrointestinal perforation or ileus: a retrospective single-center study

J Crit Care. 2013 Apr;28(2):133-40. doi: 10.1016/j.jcrc.2012.07.020. Epub 2012 Oct 16.


Purpose: We studied the effectiveness of human atrial natriuretic peptide (hANP) on management of acute kidney injury.

Methods: This 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.

Results: The 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.

Conclusion: Intravenous low dose of hANP was useful as acute kidney injury management in gastrointestinal perforation and ileus patients undergoing non-elective surgery.

MeSH terms

  • Acute Kidney Injury / prevention & control*
  • Aged
  • Aged, 80 and over
  • Atrial Natriuretic Factor / administration & dosage*
  • Atrial Natriuretic Factor / therapeutic use
  • Comorbidity
  • Creatinine / blood
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Ileus / surgery*
  • Intestinal Perforation / surgery*
  • Kidney Function Tests
  • Male
  • Perioperative Care / methods*
  • Recombinant Proteins
  • Retrospective Studies


  • Recombinant Proteins
  • Atrial Natriuretic Factor
  • Creatinine