Key result
Levosimendan lowers serum creatinine and reduces acute renal failure ~25% in left ventricular dysfunction.
Why the study?
It remains uncertain whether levosimendan can improve renal function in patients with left ventricular dysfunction.
Does levosimendan improve renal function and reduce acute renal failure in cardiovascular patients with left ventricular dysfunction?
Meta-Analysis (n=5,069)
Does levosimendan improve renal function and reduce acute renal failure in cardiovascular patients with left ventricular dysfunction?
Levosimendan therapy is associated with improved renal function and a reduced risk of acute renal failure in patients with left ventricular dysfunction.
Answers are grounded in this paper and cite their sources.
Supports levosimendan for renal protection in LV dysfunction; extends meta-analytic confirmation of cardiorenal benefits.
Objective Levosimendan, an inotrope, is widely used in the management of heart failure (HF) and cardiac surgery, but it remains uncertain whether levosimendan can improve renal function in patients with left ventricular dysfunction (LVD).Methods PubMed, Embase, and Cochrane CENTRAL from the inception to June 2020 were systematically screened for randomized controlled trials (RCTs) to investigate whether levosimendan offers kidney-related advantages in cardiovascular patients with LVD. We pooled the effects using a random-effect model.Results Twenty-eight studies enrolling 5069 patients were included. Levosimendan reduced the sCr (SMD −0.28, 95% CI (−0.48, −0.09), P = 0.005, I2 = 52.5%, high quality) and the risk of ARF (relative risk 0.75, 95%CI (0.60, 0.95), P = 0.017, I2 = 11.3%, moderate-quality) in patients with LVD compared with control group. The reduction of sCr was more pronounced in patients with a relatively higher baseline sCr level. For secondary outcomes, levosimendan therapy was associated with the improvement of GFR (SMD 0.32, 95%CI (−0.05, 0.68), P = 0.092, I2 = 55.1%, low-quality) and urine output (SMD 0.42, 95%CI (0.06, 0.79), P = 0.024, I2 = 50.0%, very low-quality), but there was no significant reduction in BUN (SMD −0.14, 95%CI (−0.97, 0.70), P = 0.774, I2 = 77.9%, very low-quality).Conclusions Levosimendan might improve renal function of patients with LVD.
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Long et al. (2021) conducted a meta-analysis in Left ventricular dysfunction (n=5,069). Levosimendan vs. Control group was evaluated on Serum creatinine (sCr) (SMD -0.28, 95% CI -0.48 to -0.09, p=0.005). Levosimendan significantly reduced serum creatinine (SMD -0.28; 95% CI -0.48 to -0.09; P=0.005) and the risk of acute renal failure (RR 0.75) in patients with left ventricular dysfunction.
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