薬理と治療

Abstract

Objectives Efficacy and safety of the Carperitide（α−human atrial natriuretic peptide）wereinvestigated in patients with acute renal failure for exploratory purposes multicenter prospectivestudy.Methods Thirty−three acute renal failure patients with pre−defined criteria of high serumcreatinine and low creatinine clearance were enrolled into this study. Carperitide was administeredat a start dose of 0.05μg・kg−1・min−1 by continuous intravenous infusion for maximumof 7 days.Results Infusion of Carperitide increased the creatinine clearance significantly and suppressedthe further increase in serum creatinine. In the oliguric acute renal failure patients,defined as＜30 mL・hr−1 at the baseline, increase of urine volume were observed. The mortalityrate at day 21 was 10.0％. The probability of dialysis and dialysis−free survival rate atday 21 were 6.3％ and 84.4％, respectively. For safety, the decrease of blood pressureoccurred in 15 patients（45.5％）, however, these events did not result in serious problemsclinically. Additionally, worsening renal function associated with the decrease in blood pressurewas not observed.Conclusions These results suggested that infusion of Carperitide in patients with acuterenal failure showed improvement of the renal functions, favorable prognosis and no significantadverse events.（Jpn Pharmacol Ther 2009；37：577−85）KEY WORDS Acute renal failure, Atrial natriuretic peptide, Carperitide, Clinical trial