Therapeutic Use of the Natriuretic Peptide Ularitide in Acute Renal Failure

Abstract

In summary, the incidence of mechanical renal replacement therapy in critically ill patients suffering from oliguric acute renal failure could not be altered positively by Ularitide administration according to our protocol. Further prospective clinical trials are needed to answer the question whether a different patient collective or a prophylactic administration of Ularitide are more promising approaches in the clinical setting of oliguric acute renal failure.

Atrial Natriuretic Peptide for Management of Acute Kidney Injury

“…Four studies in the treatment cohort included participants with established oliguric AKI (22,(31)(32)(33). One study (22) included a subgroup of patients with oliguric AKI, whereas three other studies (31-33) included all participants with oliguria.…”

“…In the prevention cohort, five studies were of low quality (24,25,30,37,38), five were of moderate quality (21,27,28,35,36), and one was of high quality (23). Among the treatment studies, one was of low quality (34), four were of moderate quality (26,29,32,33), and three were of high quality (22,31,39).…”

“…Dose, duration, and preparations of ANP varied among studies. Six studies used urodilatin preparations (23,26,29,30,32,33), and other studies used human ANP preparation. Most of the prevention studies were conducted with low-dose ANP preparations (21,24,25,27,30,(35)(36)(37)(38).…”

“…To overcome this limitation, we performed a post hoc analysis for a composite outcome of mortality or RRT requirement during the study period and/or within 30 d. The information required to compute this composite outcome was available in 16 studies (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(35)(36)(37)(38)(39), and results were generally similar to those observed regarding the need for RRT outcome for both prevention and treatment cohorts. We contacted the original study authors of the three studies for which the information needed to analyze this composite outcomes was not available (32)(33)(34); however, none of the authors could provide this information. Despite these limitations, our results provide the most comprehensive review to date of benefits and harms of ANP administration in the management of AKI.…”

Prevention and Treatment of Acute Renal Failure in Sepsis

“…The study was criticized for administering anaritide too late, too shortly, and at an excessive dose, the latter leading to hypotension and jeopardizing renal perfusion. In two randomized placebo-controlled trials in critically ill patients with ARF, a long-term (Ͼ96-h and 5-d, respectively) infusion of urodilatine did not improve renal function or reduce the need for renal replacement therapy (87)(88).…”