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.	孙鹏伟, 贾高鹏, 皇甫卫忠. 造影剂肾病研究进展. 中国医药科学, 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, 欧柏青, 向羿, 等. 中医药防治经皮冠脉介入术后造影剂肾病的研究进展. 中医药导报, 2022, 28(4): 201-205.
5.	吴夕霞, 何玉腊. 术后 JBI 规范化饮水指导对心血管介入术后患者肾功能保护的影响. 中国医药导报, 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.	黄晓佳, 梅敏, 李成德, 等. 脑钠肽、同型半胱氨酸及肌钙蛋白 I 在慢性心力衰竭中的表达及临床意义. 检验医学与临床, 2016, 13(13): 1852-1854.
8.	巴文强, 李艳, 陈力群, 等. 脑利钠肽预防造影剂肾病疗效的 meta 分析. 中南药学, 2021, 19(2): 338-345.
9.	张赤道, 吴文俊, 邢作英, 等. 复方丹参注射液联合西医治疗慢性肺源性心脏病心力衰竭疗效的 Meta 分析. 中西医结合心脑血管病杂志, 2024, 22(5): 786-794.
10.	施春燕, 何娟, 苏彤, 等. 重组人脑利钠肽对急性非 ST 段抬高型心肌梗死急诊经皮冠状动脉介入治疗后造影剂肾病的预防作用. 临床医学研究与实践, 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.	冯俊, 余世成, 孙召金, 等. 重组人脑利钠肽对老年急性心肌梗死患者直接介入术后预防造影剂肾病的保护作用. 中华老年心脑血管病杂志, 2021, 23(5): 487-490.
13.	张昊, 李广平, 陈康寅. 重组人 B 型脑利钠肽对急性心肌梗死患者急诊经皮冠状动脉介入治疗后对比剂肾病的预防作用. 天津医科大学学报, 2020, 26(4): 340-345.
14.	纪东华. 重组人脑利钠肽预处理对 AMI 介入治疗患者心肾功能及造影剂肾病发生率的影响. 中国医学创新, 2019, 16(20): 63-67.
15.	汪兵, 庹田. 重组人脑利钠肽在急性心肌梗死 PCI 后患者心肾功能的保护作用. 药物生物技术, 2019, 26(2): 136-139.
16.	陈楚, 潘丽华, 陆齐. 小剂量 rhBNP 对老年冠心病患者造影剂肾病的预防作用. 山东医药, 2018, 58(20): 55-57.
17.	魏立业, 夏岳, 张晓婵, 等. 重组人脑利钠肽对行直接介入治疗的急性心肌梗死患者心肾保护作用. 中华老年心脑血管病杂志, 2017, 19(2): 156-159.
18.	李益民, 王治, 陆治平, 等. 重组脑利钠肽对造影剂肾病的预防作用. 江苏医药, 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, 姜钧文. 重组人脑利钠肽的临床应用进展. 中医药临床杂志, 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, Węgiel M, et al. Risk factors of contrast-induced nephropathy in patients with acute coronary syndrome. Kardiol Pol, 2022, 80(7/8): 760-764.

1. 孙鹏伟, 贾高鹏, 皇甫卫忠. 造影剂肾病研究进展. 中国医药科学, 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, 欧柏青, 向羿, 等. 中医药防治经皮冠脉介入术后造影剂肾病的研究进展. 中医药导报, 2022, 28(4): 201-205.
5. 吴夕霞, 何玉腊. 术后 JBI 规范化饮水指导对心血管介入术后患者肾功能保护的影响. 中国医药导报, 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. 黄晓佳, 梅敏, 李成德, 等. 脑钠肽、同型半胱氨酸及肌钙蛋白 I 在慢性心力衰竭中的表达及临床意义. 检验医学与临床, 2016, 13(13): 1852-1854.
8. 巴文强, 李艳, 陈力群, 等. 脑利钠肽预防造影剂肾病疗效的 meta 分析. 中南药学, 2021, 19(2): 338-345.
9. 张赤道, 吴文俊, 邢作英, 等. 复方丹参注射液联合西医治疗慢性肺源性心脏病心力衰竭疗效的 Meta 分析. 中西医结合心脑血管病杂志, 2024, 22(5): 786-794.
10. 施春燕, 何娟, 苏彤, 等. 重组人脑利钠肽对急性非 ST 段抬高型心肌梗死急诊经皮冠状动脉介入治疗后造影剂肾病的预防作用. 临床医学研究与实践, 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. 冯俊, 余世成, 孙召金, 等. 重组人脑利钠肽对老年急性心肌梗死患者直接介入术后预防造影剂肾病的保护作用. 中华老年心脑血管病杂志, 2021, 23(5): 487-490.
13. 张昊, 李广平, 陈康寅. 重组人 B 型脑利钠肽对急性心肌梗死患者急诊经皮冠状动脉介入治疗后对比剂肾病的预防作用. 天津医科大学学报, 2020, 26(4): 340-345.
14. 纪东华. 重组人脑利钠肽预处理对 AMI 介入治疗患者心肾功能及造影剂肾病发生率的影响. 中国医学创新, 2019, 16(20): 63-67.
15. 汪兵, 庹田. 重组人脑利钠肽在急性心肌梗死 PCI 后患者心肾功能的保护作用. 药物生物技术, 2019, 26(2): 136-139.
16. 陈楚, 潘丽华, 陆齐. 小剂量 rhBNP 对老年冠心病患者造影剂肾病的预防作用. 山东医药, 2018, 58(20): 55-57.
17. 魏立业, 夏岳, 张晓婵, 等. 重组人脑利钠肽对行直接介入治疗的急性心肌梗死患者心肾保护作用. 中华老年心脑血管病杂志, 2017, 19(2): 156-159.
18. 李益民, 王治, 陆治平, 等. 重组脑利钠肽对造影剂肾病的预防作用. 江苏医药, 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, 姜钧文. 重组人脑利钠肽的临床应用进展. 中医药临床杂志, 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, Węgiel 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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