Efficacy and safety of recombinant human brain natriuretic peptide in preventing contrast induced nephronpathy: a meta-analysis_West China Medical Journal

Authors：

XU Mengjun ¹ , YAN Ruifeng ¹ , NI Zhijun ¹ , BAI Jiali ² ,  GUO Ning ¹

1. Cardiology Department, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, Jiangsu 215100, P. R. China;
2. Suzhou Vocational Health College, Suzhou, Jiangsu 215009, P. R. China;

Corresponding?author：

GUO Ning, Email: 82400675@qq.com

Keywords：

Recombinant human brain natriuretic peptide; contrast induced nephronpathy; meta-analysis

DOI：

10.7507/1002-0179.202403170

Video：

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Objective To systematically evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in preventing contrast induced nephronpathy (CIN). Methods Randomized controlled trials using rhBNP for the prevention of CIN were retrieved from China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library between the establishment of databases and December 31, 2024. RevMan 5.3 software was used for meta-analysis. Results A total of 12 articles were included. The meta-analysis results showed that compared with the saline group, the rhBNP group had a lower incidence of CIN [relative risk (RR)=0.39], blood creatinine levels at 48 hours [(standardized mean difference (SMD)=?0.79] and 72 hours (SMD=?0.68), cystatin C levels at 48 hours (SMD=?0.44) and 72 hours (SMD=?0.72), incidence of adverse events (RR=0.53), and higher eGFR at 48 hours [mean difference (MD)=4.62] and 72 hours (MD=7.11) after angiography. Conclusion The rhBNP may reduce the incidence and adverse events of CIN, and alleviate renal function damage after angiography.

Citation： XU Mengjun, YAN Ruifeng, NI Zhijun, BAI Jiali, GUO Ning. Efficacy and safety of recombinant human brain natriuretic peptide in preventing contrast induced nephronpathy: a meta-analysis. West China Medical Journal, 2025, 40(6): 944-948. doi: 10.7507/1002-0179.202403170 Copy

1.	孫鵬偉, 賈高鵬, 皇甫衛忠. 造影劑腎病研究進展. 中國醫藥科學, 2024, 14(15): 48-51, 125.
2.	Zhang F, Lu Z, Wang F. Advances in the pathogenesis and prevention of contrast-induced nephropathy. Life Sci, 2020, 259: 118379.
3.	Ali ZA, Escaned J, Dudek D, et al. Strategies for renal protection in cardiovascular interventions. Korean Circ J, 2022, 52(7): 485-495.
4.	李博, 歐柏青, 向羿, 等. 中醫藥防治經皮冠脈介入術后造影劑腎病的研究進展. 中醫藥導報, 2022, 28(4): 201-205.
5.	吳夕霞, 何玉臘. 術后 JBI 規范化飲水指導對心血管介入術后患者腎功能保護的影響. 中國醫藥導報, 2023, 20(21): 159-162.
6.	Cho E, Ko GJ. The pathophysiology and the management of radiocontrast-induced nephropathy. Diagnostics (Basel), 2022, 12(1): 180.
7.	黃曉佳, 梅敏, 李成德, 等. 腦鈉肽、同型半胱氨酸及肌鈣蛋白 I 在慢性心力衰竭中的表達及臨床意義. 檢驗醫學與臨床, 2016, 13(13): 1852-1854.
8.	巴文強, 李艷, 陳力群, 等. 腦利鈉肽預防造影劑腎病療效的 meta 分析. 中南藥學, 2021, 19(2): 338-345.
9.	張赤道, 吳文俊, 邢作英, 等. 復方丹參注射液聯合西醫治療慢性肺源性心臟病心力衰竭療效的 Meta 分析. 中西醫結合心腦血管病雜志, 2024, 22(5): 786-794.
10.	施春燕, 何娟, 蘇彤, 等. 重組人腦利鈉肽對急性非 ST 段抬高型心肌梗死急診經皮冠狀動脈介入治療后造影劑腎病的預防作用. 臨床醫學研究與實踐, 2023, 8(23): 17-20.
11.	Zhang YJ, Yin L, Li J. Protective effect of recombinant human brain natriuretic peptide against contrast-induced nephropathy in elderly acute myocardial infarction patients: a randomized controlled trial. World J Clin Cases, 2022, 10(33): 12221-12229.
12.	馮俊, 余世成, 孫召金, 等. 重組人腦利鈉肽對老年急性心肌梗死患者直接介入術后預防造影劑腎病的保護作用. 中華老年心腦血管病雜志, 2021, 23(5): 487-490.
13.	張昊, 李廣平, 陳康寅. 重組人 B 型腦利鈉肽對急性心肌梗死患者急診經皮冠狀動脈介入治療后對比劑腎病的預防作用. 天津醫科大學學報, 2020, 26(4): 340-345.
14.	紀東華. 重組人腦利鈉肽預處理對 AMI 介入治療患者心腎功能及造影劑腎病發生率的影響. 中國醫學創新, 2019, 16(20): 63-67.
15.	汪兵, 庹田. 重組人腦利鈉肽在急性心肌梗死 PCI 后患者心腎功能的保護作用. 藥物生物技術, 2019, 26(2): 136-139.
16.	陳楚, 潘麗華, 陸齊. 小劑量 rhBNP 對老年冠心病患者造影劑腎病的預防作用. 山東醫藥, 2018, 58(20): 55-57.
17.	魏立業, 夏岳, 張曉嬋, 等. 重組人腦利鈉肽對行直接介入治療的急性心肌梗死患者心腎保護作用. 中華老年心腦血管病雜志, 2017, 19(2): 156-159.
18.	李益民, 王治, 陸治平, 等. 重組腦利鈉肽對造影劑腎病的預防作用. 江蘇醫藥, 2017, 43(2): 111-113.
19.	Sun C, Zhi J, Bai X, et al. Comparison of the efficacy of recombinant human brain natriuretic peptide with saline hydration in preventing contrast-induced nephropathy in patients undergoing coronary angiography with or without concomitant percutaneous coronary intervention. Int J Clin Exp Med, 2015, 8(8): 14166-14172.
20.	Liu JM, Xie YN, Gao ZH, et al. Brain natriuretic peptide for prevention of contrast-induced nephropathy after percutaneous coronary intervention or coronary angiography. Can J Cardiol, 2014, 30(12): 1607-1612.
21.	Zhang J, Fu X, Jia X, et al. B-type natriuretic peptide for prevention of contrast-induced nephropathy in patients with heart failure undergoing primary percutaneous coronary intervention. Acta Radiol, 2010, 51(6): 641-648.
22.	Waheed S, Choi MJ. Trials and tribulations of diagnosing and preventing contrast-induced acute kidney injury. J Thorac Cardiovasc Surg, 2021, 162(5): 1581-1586.
23.	郎文, 姜鈞文. 重組人腦利鈉肽的臨床應用進展. 中醫藥臨床雜志, 2019, 31(1): 188-191.
24.	Yuan Y, Qiu H, Hu XY, et al. Relationship between high level of estimated glomerular filtration rate and contrast-induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention. Chin Med J (Engl), 2018, 131(17): 2041-2048.
25.	Gu G, Yu N, Zhou Y, et al. Elevation of preoperative cystatin C as an early predictor of contrast-induced nephropathy in patients receiving percutaneous coronary intervention. Singapore Med J, 2022, 63(8): 450-455.
26.	He Y, Deng Y, Zhuang K, et al. Predictive value of cystatin C and neutrophil gelatinase-associated lipocalin in contrast-induced nephropathy: a meta-analysis. PLoS One, 2020, 15(4): e0230934.
27.	Rakowski T, Dziewierz A, W?giel M, et al. Risk factors of contrast-induced nephropathy in patients with acute coronary syndrome. Kardiol Pol, 2022, 80(7/8): 760-764.

1. 孫鵬偉, 賈高鵬, 皇甫衛忠. 造影劑腎病研究進展. 中國醫藥科學, 2024, 14(15): 48-51, 125.
2. Zhang F, Lu Z, Wang F. Advances in the pathogenesis and prevention of contrast-induced nephropathy. Life Sci, 2020, 259: 118379.
3. Ali ZA, Escaned J, Dudek D, et al. Strategies for renal protection in cardiovascular interventions. Korean Circ J, 2022, 52(7): 485-495.
4. 李博, 歐柏青, 向羿, 等. 中醫藥防治經皮冠脈介入術后造影劑腎病的研究進展. 中醫藥導報, 2022, 28(4): 201-205.
5. 吳夕霞, 何玉臘. 術后 JBI 規范化飲水指導對心血管介入術后患者腎功能保護的影響. 中國醫藥導報, 2023, 20(21): 159-162.
6. Cho E, Ko GJ. The pathophysiology and the management of radiocontrast-induced nephropathy. Diagnostics (Basel), 2022, 12(1): 180.
7. 黃曉佳, 梅敏, 李成德, 等. 腦鈉肽、同型半胱氨酸及肌鈣蛋白 I 在慢性心力衰竭中的表達及臨床意義. 檢驗醫學與臨床, 2016, 13(13): 1852-1854.
8. 巴文強, 李艷, 陳力群, 等. 腦利鈉肽預防造影劑腎病療效的 meta 分析. 中南藥學, 2021, 19(2): 338-345.
9. 張赤道, 吳文俊, 邢作英, 等. 復方丹參注射液聯合西醫治療慢性肺源性心臟病心力衰竭療效的 Meta 分析. 中西醫結合心腦血管病雜志, 2024, 22(5): 786-794.
10. 施春燕, 何娟, 蘇彤, 等. 重組人腦利鈉肽對急性非 ST 段抬高型心肌梗死急診經皮冠狀動脈介入治療后造影劑腎病的預防作用. 臨床醫學研究與實踐, 2023, 8(23): 17-20.
11. Zhang YJ, Yin L, Li J. Protective effect of recombinant human brain natriuretic peptide against contrast-induced nephropathy in elderly acute myocardial infarction patients: a randomized controlled trial. World J Clin Cases, 2022, 10(33): 12221-12229.
12. 馮俊, 余世成, 孫召金, 等. 重組人腦利鈉肽對老年急性心肌梗死患者直接介入術后預防造影劑腎病的保護作用. 中華老年心腦血管病雜志, 2021, 23(5): 487-490.
13. 張昊, 李廣平, 陳康寅. 重組人 B 型腦利鈉肽對急性心肌梗死患者急診經皮冠狀動脈介入治療后對比劑腎病的預防作用. 天津醫科大學學報, 2020, 26(4): 340-345.
14. 紀東華. 重組人腦利鈉肽預處理對 AMI 介入治療患者心腎功能及造影劑腎病發生率的影響. 中國醫學創新, 2019, 16(20): 63-67.
15. 汪兵, 庹田. 重組人腦利鈉肽在急性心肌梗死 PCI 后患者心腎功能的保護作用. 藥物生物技術, 2019, 26(2): 136-139.
16. 陳楚, 潘麗華, 陸齊. 小劑量 rhBNP 對老年冠心病患者造影劑腎病的預防作用. 山東醫藥, 2018, 58(20): 55-57.
17. 魏立業, 夏岳, 張曉嬋, 等. 重組人腦利鈉肽對行直接介入治療的急性心肌梗死患者心腎保護作用. 中華老年心腦血管病雜志, 2017, 19(2): 156-159.
18. 李益民, 王治, 陸治平, 等. 重組腦利鈉肽對造影劑腎病的預防作用. 江蘇醫藥, 2017, 43(2): 111-113.
19. Sun C, Zhi J, Bai X, et al. Comparison of the efficacy of recombinant human brain natriuretic peptide with saline hydration in preventing contrast-induced nephropathy in patients undergoing coronary angiography with or without concomitant percutaneous coronary intervention. Int J Clin Exp Med, 2015, 8(8): 14166-14172.
20. Liu JM, Xie YN, Gao ZH, et al. Brain natriuretic peptide for prevention of contrast-induced nephropathy after percutaneous coronary intervention or coronary angiography. Can J Cardiol, 2014, 30(12): 1607-1612.
21. Zhang J, Fu X, Jia X, et al. B-type natriuretic peptide for prevention of contrast-induced nephropathy in patients with heart failure undergoing primary percutaneous coronary intervention. Acta Radiol, 2010, 51(6): 641-648.
22. Waheed S, Choi MJ. Trials and tribulations of diagnosing and preventing contrast-induced acute kidney injury. J Thorac Cardiovasc Surg, 2021, 162(5): 1581-1586.
23. 郎文, 姜鈞文. 重組人腦利鈉肽的臨床應用進展. 中醫藥臨床雜志, 2019, 31(1): 188-191.
24. Yuan Y, Qiu H, Hu XY, et al. Relationship between high level of estimated glomerular filtration rate and contrast-induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention. Chin Med J (Engl), 2018, 131(17): 2041-2048.
25. Gu G, Yu N, Zhou Y, et al. Elevation of preoperative cystatin C as an early predictor of contrast-induced nephropathy in patients receiving percutaneous coronary intervention. Singapore Med J, 2022, 63(8): 450-455.
26. He Y, Deng Y, Zhuang K, et al. Predictive value of cystatin C and neutrophil gelatinase-associated lipocalin in contrast-induced nephropathy: a meta-analysis. PLoS One, 2020, 15(4): e0230934.
27. Rakowski T, Dziewierz A, W?giel M, et al. Risk factors of contrast-induced nephropathy in patients with acute coronary syndrome. Kardiol Pol, 2022, 80(7/8): 760-764.

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Efficacy and safety of recombinant human brain natriuretic peptide in preventing contrast induced nephronpathy: a meta-analysis

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