The effects of levosimendan on renal function early after heart transplantation: results from a pilot randomized trial.
Clin Transplant
; 28(10): 1105-11, 2014 Oct.
Article
in En
| MEDLINE
| ID: mdl-25053182
ABSTRACT
BACKGROUND:
We evaluated the effects of a levosimendan (LS)-based strategy compared with standard inotropic therapy on renal function in heart transplantation. METHODS ANDRESULTS:
Using a randomized study design, 94 patients were assigned to LS-based therapy or standard inotropic support. At the time of transplantation, the groups did not differ in age, gender, heart failure etiology, hemodynamic profile, LVEF, or comorbidities. While there were no differences in serum creatinine (sCr) or eGFR between groups at baseline, patients in the LS group had a greater increase in their relative eGFR (62% vs. 12%, p = 0.002) and a lower incidence of acute kidney injury (AKI) (28% vs. 6%, p = 0.01) during the first post-transplant week. On logistic regression analysis, correlates of AKI were randomization to LS therapy (OR = 0.21 [0.09-0.62], p = 0.01), baseline renal dysfunction (OR = 3.9 [1.1-13.6], p = 0.032), and diabetes mellitus (OR = 4.2 [1.1-16.5], p = 0.038). However, LS was associated with a greater need for additional norepinephrine therapy (40 [85%] vs. 15 [31%], p < 0.001) and a trend toward longer intensive care unit stay (9.5 ± 9.0 d vs. 7.0 ± 6.0 d, p = 0.13).CONCLUSIONS:
In patients undergoing heart transplantation, levosimendan-based strategy may be associated with better renal function when compared to standard therapy.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pyridazines
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Cardiotonic Agents
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Heart Transplantation
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Heart Failure
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Hydrazones
/
Kidney
Type of study:
Clinical_trials
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Etiology_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Clin Transplant
Journal subject:
TRANSPLANTE
Year:
2014
Type:
Article
Affiliation country:
Slovenia