PURPOSE: We assessed the hypothesis that chronic Nesiritide therapy worsens renal function in patients with chronic heart failure.
METHODS: This is a retrospective analysis of charts of patients with class III NYHA who were being treated with weekly IV injections of Nesiritide at a dose of 0.01 mcg/kg/minute at the heart failure clinic in SIUH. Serum creatinine levels were followed at baseline, at 3 and at 6 months. The differences between groups, the effects of gender and time from starting Nesiritide on serum creatinine, were assessed using ANOVA.
RESULTS: 63 charts were analysed. 43 patients (68.25%) were males. The mean age (+SD) was 72.91 + 14.38 for men and 79.60 + 9.38 for women. 44.18 % of males and 40 % of female patients were diabetic. At 6 months follow up, there were 43 patients, 30 males and 13 females. The rest of the patients either died or left the program.Compared to baseline there was a statistically significant increase in serum creatinine at 3 months and 6 months, 10.98% (p 0.041) and 7.61% (p 0.001) respectively, Table I. When the groups were gender stratified, male patients had a statistically significant increase in serum creatinine at 3 months and 6 months, 12.56% (p 0.001) and 10.7% (p 0.013) respectively. However, in female patients, the change in serum creatinine at 3 months and 6 months did not meet statistical significance when compared to baseline; 7.11% (p 0.287) and −0.469% (p 0.949) at 3 and 6 months respectively.Comparison of changes of creatinine from baseline of males to females showed a statistically significant difference between the groups at 3 months (p 0.085) and 6 months (p 0.038).
CONCLUSION: The use of Nesiritide worsened renal function in our study population. The difference in outcome between groups can be partially explained by the higher creatinine levels at baseline in male patients and probably the higher incidence of diabetes in this group.
CLINICAL IMPLICATIONS: Weekly outpatient therapy with Nesiritide worsens renal function in patient with chronic heart failure.
DISCLOSURE: Mohammad-Ali El-Harakeh, No Financial Disclosure Information; No Product/Research Disclosure Information