Atrial natriuretic factor in oliguric acute renal failure

Diagnosis and Treatment of Acute Tubular Necrosis

“…In a study of 53 patients with established ATN randomly assigned to atrial natriuretic peptide or placebo, intrarenal and intravenous atrial natriuretic peptide improved creatinine clearance and decreased the need for dialysis (58). Subsequent larger randomized trials, however, failed to confirm this benefit (59,60). The decrease in blood pressure during intravenous atrial natriuretic peptide therapy may have obscured any beneficial renal effects.…”

Prevention and Treatment of Acute Renal Failure in Sepsis

“…In non-oliguric patients, however, anaritide worsened dialysis-free survival. To further examine the potential benefit of anaritide in oliguric patients, a randomized placebocontrolled trial was conducted in 222 oliguric ARF patients (35% with sepsis) (86). Anaritide (24-h) conferred a nonsignificant trend toward improved 14-d and 21-d dialysis-free survival, but 60-d mortality rates were similar to placebo.…”

Refining Predictive Models in Critically Ill Patients with Acute Renal Failure

“…Despite improvements in intensive care and dialytic technology, particularly with continuous renal replacement therapies, we have not observed meaningful improvements in patient survival over the past three decades (4 -8). In most series, more than 50% of patients with hospital-acquired ARF die before hospital discharge; of those who survive, between 10 and 33% require long-term dialysis (9 -11).Over the past decade, several clinical trials have been conducted, aiming to reduce ARF-associated mortality (12)(13)(14). Most of these studies have unfortunately proved unsuccessful, including relatively large, well-designed trials using pharmacologic agents with strong preclinical data (e.g., atrial natriuretic peptide [ANP]).…”