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Effect of nesiritide on renal function: a retrospective review
Judy W M Cheng1, Man Yee Merl, Huan M Nguyen
1Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY 10029, USA. judy.cheng@liu.edu
Current Medical Research and Opinion
|November 26, 2005
Summary
Nesiritide did not significantly impact renal function (RF) in patients with acute decompensated heart failure (ADHF). This study found no significant difference in RF changes compared to diuretics alone, suggesting RF preservation is not a primary concern.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Recent meta-analyses suggest nesiritide may negatively affect renal function (RF) in acute decompensated heart failure (ADHF).
- Institutional evaluations indicated a belief in RF preservation as a factor in nesiritide overuse.
- This study aimed to evaluate nesiritide's actual impact on RF.
Purpose of the Study:
- To examine the effect of nesiritide on renal function (RF) in patients with ADHF.
- To assess whether nesiritide use influences changes in creatinine clearance (CrCl).
- To determine if nesiritide is associated with worsening RF compared to standard diuretic therapy.
Main Methods:
- Retrospective review of 162 patient records from October 2003 to March 2004.
- Comparison of changes in CrCl before, during, and after nesiritide initiation.
- Statistical analysis using Wilcoxon Signed-Ranks test and Chi-Square test.
Main Results:
- Nesiritide addition to IV furosemide did not significantly alter RF compared to IV furosemide alone (0% vs. -2.13% change in CrCl).
- No significant differences in CrCl changes or the percentage of patients with worsening RF (> or = 25% decrease) were observed between groups.
- RF changes were not correlated with nesiritide dose or duration of therapy.
Conclusions:
- Nesiritide demonstrated no significant impact on renal function in this patient cohort.
- Further large-scale, controlled studies are needed to clarify the risk-benefit profile of nesiritide concerning RF and clinical outcomes.