The Protective Effect of Recombinant Human Brain Natriuretic Peptide on Acute Kidney Injury after Liver Transplantation

Weiwei Wang, Shuncai Liu, Chaoyang Li, Tao Han, Ting Jiang, Yan Chen, Quan Cao and Jinhai Li

Department of Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, China Department of Critical Care Medicine, The Third People's Hospital of Xining City, China Emergency Center, The First Affiliated Hospital of Nanjing Medical University, China These authors contributed equally to the work

^*Correspondance to: Jinhai Li, Quan Cao, Yan Chen 

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Abstract:

Background: To investigate the protective effect of recombinant human Brain Natriuretic Peptide (rhBNP) on Acute Renal Injury (AKI) after liver transplantation. Methods: A retrospective cohort study was analyzed by collecting clinical and epidemiological data of 136 patients who underwent liver transplantation from March 2018 to December 2020. Patients were divided into rhBNP group (88 cases) and non-rhBNP group (48 cases) according to whether they were treated with rhBNP after the operation. The changes of liver and renal function after operation and the difference of clinical prognosis were studied. Results: Patients (50.0%) in non-rhBNP group had a significantly higher incidence of AKI than those (31.8%) in rhBNP group (P=0.04), especially the AKI stage I. Average levels of serum creatinine within seven days were significantly lower in the rhBNP group than that in the non-rhBNP group (P=0.01). The rate of postoperative CRRT did not differ significantly between the two groups. However, the use of furosemide was significantly greater in the non-rhBNP group (P<0.001). The in-hospital mortality rate after liver transplantation was 18.2% in the rhBNP group and 22.9% in the non-rhBNP group. The mean length of Intensive Care Unit (ICU) stay in the rhBNP group was 2.9 ± 5.0 days, significantly shorter than the 6.4 ± 16.2 days in the non-rhBNP group (P=0.02). There were significant differences in the survival distributions of patients after liver transplantation with AKI versus non-AKI (P<0.001) by Kaplan-Meier curve analysis. Conclusion: The application of rhBNP in patients after liver transplantation could reduce kidney injury, reduce the risk of postoperative AKI, increased urine volume after surgery, decrease the length of stay in ICU and improve the clinical prognosis of patients. It provided a new path for the clinical prevention and treatment of AKI after liver transplantation.

Keywords:

rhBNP; Acute kidney injury; Liver transplantation; ICU

Cite the Article:

Wang W, Liu S, Li C, Han T, Jiang T, Chen Y, et al. The Protective Effect of Recombinant Human Brain Natriuretic Peptide on Acute Kidney Injury after Liver Transplantation. Ann Clin Case Rep. 2021; 6: 1963..