Efficacy Of RhBNP For The Treatment Of Cardiorenal Syndrome After Cardiac Surgery

Objective: Heart kidney syndrome(CRS) is to point that in the pathological state, by any acute or chronic damage of the heart or kidney function, leading to another organ function of acute or chronic damage. Not correcting heart failure, cardiac output reduce lead to renal perfusion, cause kidney damage; Kidney function is damaged, reduced glomerular filtration rate(GFR), reduced the volume of urine, increase cardiac preload, aggravating heart function failure. It is lack of certain treatment for the CRS, but treatment focus has shifted from the simple to improve hemodynamics to block excessive activation of neurohumoral and cytokines in patients. Recombinant human brain natriuretic peptide(rh BNP) can inhibit the activation of aldosterone – renin – angiotensin(RAAS) and sympathetic nervous system, and a large number of literature has reported the application of rh BNP in congestive heart failure, but the application of rh BNP in CRS patients after cardiac surgery is rare. In this paper, the application of rh BNP in CRS after cardiac surgery is observed and evaluated, and its possible mechanism is studied.Methods: Fifty patients with cardiorenal syndrome after cardiac surgery failed to the routine therapy with dopaminergics, diuretics, nitrates and milrinone, and then were given rh BNP intravenous pump for 48 h. The efficacy was observed.Results:After the additional treatment with rh BNP, the urine volume was obviously increased; serum creatinine(Scr) and blood urea nitrogen(BUN) was decreased; estimate glomerular filtration rate(e GFR) was increased; central venous pressure(CVP) reduced; and artery blood pressure(ABP) including both systolic and diastolic blood pressure was increased. After 48 hour, blood brain natriuretic peptide was lowered and the left ventricle ejection fraction(LVEF) was elevated 7 days later.Conclusion: Additional small dose rh BNP(<0.01 ?g/kg/min) can help improve heart and renal function of patients with cardiorenal syndrome after cardiac surgery when routine therapy has no effect, which may improve patients' renal function first, and then heart function gets improved.