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Kidney Week

Abstract: FR-PO042

Use of Nesiritide in Total Artificial Heart to Rescue From Dialysis Dependence

Session Information

  • AKI: Clinical Outcomes, Trials
    November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Author

  • Hebert, Christopher, Kidney and Hypertension Associates of Dallas, Dallas, Texas, United States
Introduction

It is well described in the literature that patients with total artificial heart implantation as a bridge to transplant have low atrial natiuretic peptide levels. Patients post ventriculectomy may lose the ability to produce urine in some cases as a consequence to having low ANP levels

Case Description

We present a 62yo man who underwent total artificial heart implantation. Post operatively, he developed severe shock and was placed on VA ECMO as well as CRRT. He was initially on niseritide post operatively but after a relatively quick decannulation and cessation of niseritide in 48 hours, he became anuric and required ongoing hemodialysis. After 10 days of hemodialysis, it was decided to restart niseritide as a trial to see if we could promote some urine production. On day 1, he made a liter of urine and by day 6 his creatinine had gone from 6 down to 1.3 and he no longer required dialysis. He was discharged home and received a heart transplant a month later. To date, he remains off dialysis with creatinine level of 1.0

Discussion

There are a few case reports detailing such a response to niseritide. This particular case was an extreme example of a patient going from an anuric state on hemodialysis with really no ability to discharge him from the hospital, to making ample urine and recovering renal function.