Effects of atrial natriuretic peptide in clinical acute renal failure

Effects of atrial natriuretic peptide in clinical acute renal failure. Fifty-three consenting patients meeting clinical and urine composition criteria for established intrinsic ARF were assigned to two treatment groups. Group I patients were treated with human atrial natriuretic peptide (ANP) with or without diuretics. Groups II patients were treated with or without diuretics and with no ANP. Age, sex, etiology of ARF, entry serum creatinines (S Cr ) (Group I, 5.3 ± 1.8; Group II, 5.1 ± 2.1 mg/dl) and creatinine clearances (C Cr ) (Group I, 9.9 ± 2.1; Group II, 9.2 ± 2.1 ml/min) were similar. Thirty patients received ANP [0.20 µg/kg/min i.v. × 24hr (N = 20) or 0.08 µg/kg/min i.a. × 8hr (N = 10)] and furosemide, 0.5 mg/kg/hr × 24hr or mannitol, 12.5g every six hours × 4, or no diuretic; 23 Group II patients received diuretics as above or no diuretic in a similar distribution to Group I. C Cr (verified with simultaneous inulin clearances × 12, r=0.93, P Cr in Group II. Dialysis was required in 23% of Group I and in 52% of Group II patients (different at P Cr and reduces need for dialysis in patients with established intrinsic ARF.