medicina58巻10号

2021年09月発行

特集 腎疾患—エキスパートへの質問で学ぶ診療のキホンと最新情報 利尿薬やその他の新薬の有効性と注意すべき副作用

心不全やAKIにANP（心房性ナトリウム利尿ペプチド）を投与すべきか否か？ またその効果はあるのか？ について教えてください

著者： 山田博之¹² 横井秀基²

所属機関： ¹京都大学大学院医学研究科初期診療・救急医学 ²京都大学大学院医学研究科腎臓内科学

ページ範囲：P.1636 - P.1640

Point
◎心房性ナトリウム利尿ペプチド（ANP）は，心房の進展に応じて分泌されるペプチドホルモンで，心臓，腎臓，血管などでさまざまな作用をもたらす．
◎心不全の観点では，ANPはその強力な利尿作用によって心不全治療には大いに寄与するが，予後の改善効果はエビデンスレベルとして高いとは言えない．
◎AKIの観点では，腎代替療法の導入率を改善させる可能性がランダム化比較試験（RCT）により示されている．ただし，サンプルサイズやバイアスリスクなどの点で有効性が確立されていると言えず，さらに大規模でバイアスリスクの低いRCTが望まれる．

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