Efficacy of Carperitide in Hemodialysis Patients Undergoing Cardiac Surgery

Abstract

Purpose: Recently, performance of cardiac surgery in hemodialysis patients has increased, but the mortality rate is high. Methods: We retrospectively examined the early and long-term outcomes in 128 dialysis patients who underwent cardiac surgery with or without carperitide infusion and were followed for 2 years. Sixty-three patients received carperitide infusion during surgery and 65 patients did not. Results: The hospital mortality rate was 1.6% in the carperitide group and 12.3% in the non-carperitide group, being significantly lower in the carperitide group. The 2-year actuarial survival rate was 90.5% ± 3.7% in the carperitide group, and 76.9% ± 5.2% in the non-carperitide group, while the major adverse cardiovascular and cerebrovascular events (MACCE)-free rate at 2 years postoperatively was 90.5% ± 3.7% in the carperitide group and 67.7% ± 5.8% in the non-carperitide group. Conclusions: These findings suggest that carperitide improves the early postoperative outcome in dialysis patients undergoing cardiac surgery, as has already been demonstrated in non-dialysis patients. An early postoperative cardioprotective effect of carperitide and improvement of renal function in oliguric patients might have contributed to this outcome. However, this was a retrospective study, so a prospective investigation is required to demonstrate the mechanisms involved. In addition, further evaluation of the long-term results would be desirable.

Predictive value of circulating coagulation related microRNAs expressions for major adverse cardiac and cerebral event risk in patients undergoing continuous ambulatory peritoneal dialysis: a cohort study

“…Considering the sample sizes in these previous studies (65 and 108) are relatively small and their enrolled patients were restricted on hemodialysis patients, further study with larger sample size concerning CAPD patients is needed. In our study, we enrolled 198 ESRD patients undergoing CAPD (a relatively larger sample size), and we found that MACCE incidence at 1 year, 2 year, 3 year and 4 year was 2.5, 6.1, 9.1 and 13.1% respectively, and the mean MACCE-free survival was 45.2 (95% CI 44.0-46.4) months in CAPD patients, these results might be different compared to those previous studies, and the reasons might be: (1) MACCE incidence of our study was lower than that in one previous study, which might be due to the lower age as well as shorter dialysis duration of enrolled patients in our study [15]; (2) MACCE-free survival in our study was numerically shorter than another previous study, which might be due to the decreased follow-up duration of our study compared to the previous study [16].…”

“…In this study, we observed that: (1) MACCE incidence at 1 year, 2 year, 3 year and 4 year was 2.5, 6.1, 9.1 and 13.1% respectively in CAPD patients, and mean MACCE-free [15,16]. For instance, a study enrolling 65 hemodialysis patients discovers a 2-year MACCE incidence of 32.3%, and another study enrolling 108 hemodialysis patients shows a median cardiovascular disease-free survival of 7.63 years (95% CI 7.06-8.21 years) [15,16]. Considering the sample sizes in these previous studies (65 and 108) are relatively small and their enrolled patients were restricted on hemodialysis patients, further study with larger sample size concerning CAPD patients is needed.…”