[Cardiovascular effects of human atrial natriuretic peptide during renal transplantation]

We evaluated the cardiovascular effects of human atrial natriuretic peptide (hANP) in the recipients of renal transplantation.

Anesthesia was maintained by inhalation of nitrous-oxide and isoflurane in oxygen, with epidural block. The recipients were divided into three groups; one group received no hANP infusion as control and the other groups received continuous infusion of hANP at the rate of either 0.05 microg x kg(-1) x min(-1) or 0.1 microg x kg(-1) x min(-1). Intravenous infusion of hANP was started at the anastomosis of renal artery after the fresh frozen plasma was loaded to achieve PCWP over 17 mmHg. In each group, we examined cardiovascular changes by using a pulmonary artery catheter and transesophageal echocardiography. The measurements were done before and after 15 minutes of hANP infusion.

In comparison with control, the decreases in PCWP and CVP were significant in the 0.1 microg x kg(-1) x min(-1) group. An increase in CI and the reduction of CVP were significant in 0.05 microg x kg(-1) x min(-1) group, when compared with control group. In the 0.1 microg x kg(-1) x min(-1) group, the reductions of PCWP and CVP and MAP were significant, but the significant increase in CI was characteristic in the 0.05 microg x kg(-1) x min(-1) group.

We conclude that the low-dose infusion of hANP in the recipients of renal transplantation is useful for the optimal anesthetic care because of the cardiovascular improvement.