Evaluation of the therapeutic effect of continuous renal replacement therapy and recombinant human brain natrinretic peptid for acute renal failure after cardiac surgery

JIANG Xue-yan; HE Yi; MEI Ju

doi:10.3969/j.issn.1672-5301.2017.04.014

Abstract：Objective To evaluate the therapeutic efficiency of continuous renal replacement therapy (CRRT) and recombinant human brain natrinretic peptid (rhBNP) for acute renal failure (ARF) after cardiac surgery.Methods The clinical data of patients,with ARF undergoing cardiac surgery,was retrospectively studied.There were 47 cases given combined therapy (control group),including the application of CRRT,vasoactive drugs and other supportive therapy.A total of 42 cases were in therapy group,who were intravenously given rhBNP based on combined therapy.Urine volume,serum creatinine,left ventricular ejection fraction,cardiac index,central venous pressure,mean arterial pressure,CRRT duration and prognosis were measured before and after treatment between the two groups.Results The urine volume of the patients in the treatment group were (107.61±230.43)ml/h,(163.74±180.63)ml/h at 24 h and 72 h respectively.The serum creatinine level were (134.94±53.51)tμmol/L,(94.47±78.36)μ.mol/L respectively.There were significantly improved (P＜0.01) compared with the control group.Central venous pressure [(17.8±5.2)cm H2O,(11.4±7.7)cm H2O at 24 h and 72 h respectively in treatment group] and mean arterial pressure [(55.80±18.47)mm Hg,(89.30±16.98)mm Hg at 24 h and 72 h respectively in treatment group] compared with control group also had some improvement (P＜0.05).But there was no improvement in cardiac function (left ventricular ejection fraction,cardiac index).CRRT treatment duration,what was (89.5±23.2)h in treatment group and (175.4±26.7)h in the control group,was significantly shortened compared between the two.In the control group,except for 2 cases converted to normal daytime hemodialysis,there were 9 cases of death and 4 cases of death in the treatment group.Conclusion rhBNP may efectively improve renal function of patients with ARF undergoing cardiac surgery,shorten CRRT treatment duration and improve the prognosis.