Drug may prevent kidney failure in bypass patients

DETROIT – A drug approved for heart failure shows promise in preventing or reducing kidney failure in heart bypass patients – a costly problem estimated to add $643 million in hospital charges a year.

Natrecor, given intravenously before and after bypass surgery, helped prevent the problem, reduced costly hospital stays and improved the survival of patients in the first six months after surgery, said Dr. Robert M. Mentzer Jr., dean of the Wayne State University School of Medicine. He was the chief investigator in the study to be published in the Feb. 13 issue of the Journal of the American College of Cardiology.

The study was a so-called Phase II trial to determine the drug’s safety and effectiveness. It awaits further research.

Kidney failure is a well-established complication of both bypass surgery and of catheterization procedures performed to detect blockages, Mentzer said. He said he was paid for less than a day of work to design the study and has no business ties now to the company.

As many as 5 percent of patients have serious enough problems that they need dialysis later, and up to 15 percent of high-risk patients subsequently develop kidney failure, he said. Some studies suggest the problem is growing. An estimated 600,000 Americans undergo heart bypass surgery a year, costing an average of $44,820.

“That’s why we’ve been searching for some time to find a way to protect the kidneys during surgery,” said Mentzer, a transplant surgeon. Currently, patients get drugs to improve heart and kidney function prior to surgery but the medicines aren’t as effective as physicians would like.

The study followed 279 patients at 54 centers. Half received the drug; the rest were given a sugar pill. There were no serious complications, Mentzer said. Patients received an intravenous infusion of the drug one hour prior to surgery and as much as two days afterward.

Natrecor is made by Scios Inc. of Mountain View, Calif. It is federally approved for heart failure.