Effect of nesiritide on renal function of patients with heart failure：a systematic review

Abstract:

Objective：To assess the impact of nesiritide on renal function of patients with heart failure. Methods：All the relevant liter－atures were searched from PubMed，Embase，Cochrane Library，OVID，Wangfang，CNKI，VIP，CBM，etc. Papers of related journals and conferences were also manually searched. Then the quality of included studies and extracted data were assessed and Meta-analysis was conducted with the evaluation method recommended by the guide of Cochrane Systematic Review 5.1.0. Results：A total of 642 articles were retrieved，but only 28 randomized controlled trials were finally included. The Meta-analysis showed that there was no significant difference in rising serum creatinine（SCr），blood urea nitrogen（BUN），creatinine clearance rate（Clcr），Cystatin C between the nesiritide group and the contrast（the therapeutic dose of nitroglycerin，sodium nitrate，dobutamine，diuretics and blank）（SCr：WMD=1.97，95％CI=-1.41 to 5.34，P=0.250；BUN：WMD=-0.21，95％CI=-1.01 to 0.60，P=0.610；Clcr：WMD=4.22，95％CI=-2.67 to 11.11，P=0.230；Cystatin C：WMD=0.06，95％CI=-0.24 to 0.36，P=0.690）. Meanwhile nesiritide was better in improving glomerular filtration rate（GFR） than the contrast（WMD=12.40，95％CI=8.87 to 15.93，P=0.000）. Conclusion：Compared with the other commonly used drugs of heart failure treatment，nesiritide doesn’t significantly affect the renal function of patients with heart failure，instead of improving GFR. So it is one of the safe drugs in the treatment of heart failure.