Effect of levosimendan on renal function in background of left ventricular dysfunction: a meta-analysis of randomized trials. Issue 11 (2nd November 2021)

• Record Type: Journal Article
• Authors: Long, Yu-Xiang; Cui, Di-Yu; Kuang, Xue; Hu, Yue; Hu, Shuang; Wang, Chun-Ping; Liu, Zeng-Zhang
• Is Part Of: Expert opinion on drug safety. Volume 20:Issue 11(2021)
• Page Start: 1411
• Page End: 1420
• Publication Date: 2021-11-02
• Subjects: Levosimendan -- left ventricular dysfunction -- serum creatinine -- acute renal failure -- meta-analysis; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2021.1951700
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: 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, I 2 = 52.5%, high quality) and the risk of ARF (relative risk 0.75, 95%CI (0.60, 0.95), P = 0.017, I 2 = 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, I 2 = 55.1%, low-quality) and urine output (SMD 0.42, 95%CI (0.06, 0.79), P = 0.024, I 2 = 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, I 2 = 77.9%, very low-quality). Conclusions: Levosimendan might improve renal function of patients with LVD.