Renal Effects of Levosimendan: A Consensus Report
| Autor: | John Parissis, Mehmet Yilmaz, Markku Salmenperä, István Édes, Sascha Treskatsch, Anders Oldner, Sven-Erik Ricksten, Piero Pollesello, Elena Grossini, Ignacio Oulego Erroz, Bojan Vrtovec, Mervyn Singer, Matti Kivikko, Luis Miguel Rodríguez Fernández, Alexander Parkhomenko, Jos Le Noble, José Silva Cardoso, Gerhard Poelzl, Sebastian Rehberg, Veli-Pekka Harjola, Alexandre Mebazaa, Andrea Morelli, Julia Hasslacher, Francesco Fedele, Gerhard Wikström |
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| Jazyk: | angličtina |
| Předmět: |
Medicin och hälsovetenskap
medicine.medical_specialty Cardiotonic Agents Levosimendan Review Article Kidney Medical and Health Sciences law.invention Sepsis Randomized controlled trial law medicine Animals Humans Pharmacology (medical) Intensive care medicine Simendan Pharmacology Septic shock business.industry Organ dysfunction Hydrazones General Medicine medicine.disease Cardiac surgery Pyridazines Heart failure Renal dysfunction medicine.symptom business Cardiology and Cardiovascular Medicine medicine.drug |
| Zdroj: | Cardiovascular Drugs and Therapy |
| ISSN: | 0920-3206 |
| DOI: | 10.1007/s10557-013-6485-6 |
| Popis: | 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). |
| Databáze: | OpenAIRE |
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