Naslov
Beneficial impact of levosimendan in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials

Autori
Bove, Tiziana ; Matteazzi, Andrea ; Belletti, Alessandro ; Paternoster, Gianluca ; Saleh, Omar ; Taddeo, Daiana ; Dossi, Roberto ; Greco, Teresa ; Bradić, Nikola ; Husedžinović, Ino ; Nigro Neto, Caetano ; Lomivorotov, V. Vladimir ; Calabrò, Maria Grazia

Izvornik
Heart, lung and vessels (2282-8419) 7 (2015), 1; 35-46

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
levosimendan; acute kidney injury; critical care; renal replacement therapy

Sažetak
Introduction: The incidence of Acute Kidney Injury is nowadays high in critically ill patients. Its etiology is multifactorial and a primary role is played by low cardiac output syndrome. Everything targeted to normalize cardiac output should increase the renal perfusion and abolish the secondary vasoconstriction. Levosimendan is a calcium sensitizer drug with inotropic properties that improves cardiac output and seems to increase renal blood flow. The aim of this meta-analysis was to evaluate the role of levosimendan in critically ill patients with or at risk of Acute Kidney Injury. Methods: We performed a meta-analysis of randomized controlled trials searching for trials that compared levosimendan with any comparator. The endpoints were the number of patients receiving Renal Replacement Therapy after randomization and the number of patients developing Acute Kidney Injury. Results: Final analysis included 33 trials and 3, 879 patients (2, 024 levosimendan and 1, 855 control). The overall analysis showed that the use of levosimendan was associated with a significant reduction in the risk of Renal Replacement Therapy (17 of 492 [3.5%] in the levosimendan group versus 37 of 427 [8.7%] in the control group, relative risk =0.52 [0.32 to 0.86], p for effect =0.01) and of Acute Kidney Injury (114 of 1, 598 [7.1%] in the levosimendan group versus 143 of 1, 529 [9.4%] in the control arm, relative risk =0.79 [0.63 to 0.99], p for effect =0.048). Conclusions: This meta-analysis suggests that the use of levosimendan is associated with a significant reduction of Renal Replacement Therapy in critically ill patients.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA