Renal Effects of Levosimendan: A Consensus Report
Date
2013Author
Yilmaz, Mehmet B.Grossini, Elena
Silva Cardoso, Jose C.
Edes, Istvan
Fedele, Francesco
Pollesello, Piero
Kivikko, Matti
Harjola, Veli-Pekka
Hasslacher, Julia
Mebazaa, Alexandre
Morelli, Andrea
le Noble, Jos
Oldner, Anders
Oulego Erroz, Ignacio
Parissis, John T.
Parkhomenko, Alexander
Poelzl, Gerhard
Rehberg, Sebastian
Ricksten, Sven-Erik
Rodriguez Fernandez, Luis M.
Salmenpera, Markku
Singer, Mervyn
Treskatsch, Sascha
Vrtovec, Bojan
Wikstrom, Gerhard
Metadata
Show full item recordAbstract
Renal dysfunction is common in clinical settings in which cardiac function is compromised such as heart failure, cardiac surgery or sepsis, and is associated with high morbidity and mortality. Levosimendan is a calcium sensitizer and potassium channel opener used in the treatment of acute heart failure. This review describes the effects of the inodilator levosimendan on renal function. A panel of 25 scientists and clinicians from 15 European countries (Austria, Finland, France, Hungary, Germany, Greece, Italy, Portugal, the Netherlands, Slovenia, Spain, Sweden, Turkey, the United Kingdom, and Ukraine) convened and reached a consensus on the current interpretation of the renal effects of levosimendan described both in non-clinical research and in clinical study reports. Most reports on the effect of levosimendan indicate an improvement of renal function in heart failure, sepsis and cardiac surgery settings. However, caution should be applied as study designs differed from randomized, controlled studies to uncontrolled ones. Importantly, in the largest HF study (REVIVE I and II) no significant changes in the renal function were detected. As it regards the mechanism of action, the opening of mitochondrial K-ATP channels by levosimendan is involved through a preconditioning effect. There is a strong rationale for randomized controlled trials seeking beneficial renal effects of levosimendan. As an example, a study is shortly to commence to assess the role of levosimendan for the prevention of acute organ dysfunction in sepsis (LeoPARDS).
Source
CARDIOVASCULAR DRUGS AND THERAPYVolume
27Issue
6Collections
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