Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis

Randomized controlled trials involving natriuretic peptide administration in solid organ transplantation setting have shown inconsistent effects for renal endpoints. We conducted a systematic review and meta-analysis of these trials to ascertain the role of natriuretic peptides in the management of...

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Main Authors: Sagar U. Nigwekar, Hrishikesh Kulkarni, Charuhas V. Thakar
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:International Journal of Nephrology
Online Access:http://dx.doi.org/10.1155/2013/949357
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author Sagar U. Nigwekar
Hrishikesh Kulkarni
Charuhas V. Thakar
author_facet Sagar U. Nigwekar
Hrishikesh Kulkarni
Charuhas V. Thakar
author_sort Sagar U. Nigwekar
collection DOAJ
description Randomized controlled trials involving natriuretic peptide administration in solid organ transplantation setting have shown inconsistent effects for renal endpoints. We conducted a systematic review and meta-analysis of these trials to ascertain the role of natriuretic peptides in the management of solid organ transplantation associated acute kidney injury (AKI). MEDLINE, EMBASE, and Google scholar were searched independently by two authors for randomized trials evaluating renal effects of natriuretic peptides in solid organ transplantation settings. Two reviewers independently assessed the studies for eligibility and extracted the relevant data. The pooled estimate showed that natriuretic peptide administration is associated with a reduction in AKI requiring dialysis (odds ratio = 0.50 [0.26–0.97]), a statistically nonsignificant trend toward improvement in posttransplant creatinine clearance (weighted mean difference = 5.5 mL/min, [−1.3 to 12.2 mL/min]), and reduction in renal replacement requirement duration (weighted mean difference −44.0 hours, [−60.5 to −27.5 hours]). There were no mortality events and no adverse events related to natriuretic peptides. In conclusion, administration of natriuretic peptides in solid organ transplantation may be associated with significant improvements in renal outcomes. These observations need to be confirmed in an adequately powered, prospective multicenter study.
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spelling doaj-art-32e7ba2ff3e7425d8d072620fc6ef82c2025-08-20T02:24:21ZengWileyInternational Journal of Nephrology2090-214X2090-21582013-01-01201310.1155/2013/949357949357Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-AnalysisSagar U. Nigwekar0Hrishikesh Kulkarni1Charuhas V. Thakar2Division of Nephrology, Massachusetts General Hospital, Bulfinch 127, Boston, MA 02114, USADepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USADivision of Nephrology, University of Cincinnati, Cincinnati, OH 45220, USARandomized controlled trials involving natriuretic peptide administration in solid organ transplantation setting have shown inconsistent effects for renal endpoints. We conducted a systematic review and meta-analysis of these trials to ascertain the role of natriuretic peptides in the management of solid organ transplantation associated acute kidney injury (AKI). MEDLINE, EMBASE, and Google scholar were searched independently by two authors for randomized trials evaluating renal effects of natriuretic peptides in solid organ transplantation settings. Two reviewers independently assessed the studies for eligibility and extracted the relevant data. The pooled estimate showed that natriuretic peptide administration is associated with a reduction in AKI requiring dialysis (odds ratio = 0.50 [0.26–0.97]), a statistically nonsignificant trend toward improvement in posttransplant creatinine clearance (weighted mean difference = 5.5 mL/min, [−1.3 to 12.2 mL/min]), and reduction in renal replacement requirement duration (weighted mean difference −44.0 hours, [−60.5 to −27.5 hours]). There were no mortality events and no adverse events related to natriuretic peptides. In conclusion, administration of natriuretic peptides in solid organ transplantation may be associated with significant improvements in renal outcomes. These observations need to be confirmed in an adequately powered, prospective multicenter study.http://dx.doi.org/10.1155/2013/949357
spellingShingle Sagar U. Nigwekar
Hrishikesh Kulkarni
Charuhas V. Thakar
Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
International Journal of Nephrology
title Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
title_full Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
title_fullStr Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
title_full_unstemmed Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
title_short Natriuretic Peptides in the Management of Solid Organ Transplantation Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
title_sort natriuretic peptides in the management of solid organ transplantation associated acute kidney injury a systematic review and meta analysis
url http://dx.doi.org/10.1155/2013/949357
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AT hrishikeshkulkarni natriureticpeptidesinthemanagementofsolidorgantransplantationassociatedacutekidneyinjuryasystematicreviewandmetaanalysis
AT charuhasvthakar natriureticpeptidesinthemanagementofsolidorgantransplantationassociatedacutekidneyinjuryasystematicreviewandmetaanalysis