A study published in the Journal of the American Heart Association showed use of levosimendan helped increase GFR in patients with heart failure who also had kidney impairment.
In the paper, titled "Differential effects of levosimendan and dobutamine on glomerular filtration rate in patients with heart failure (HF) and renal impairment: A randomized double‐blind controlled trial,” Lukas Lannemyr, MD, of the Sahlgrenska University Hospital in the department of cardiothoracic anesthesia in Gothenburg, Sweden, and colleagues found that “the levosimendan-induced elevation of cardiac output not only increased [renal blood flow] RBF but also, and in contrast to dobutamine, enhanced GFR, suggesting a preferential dilation of preglomerular afferent arterioles. Based on these findings, levosimendan may be the preferred inotropic drug for treatment of patients with the cardiorenal syndrome,” they wrote.
The study enrolled 32 patients with HF and renal impairment in a randomized, double-blind, controlled trial and compared the acute renal and systemic effects of moderate doses of levosimendan (0.1 µg/kg per minute) and dobutamine (7.5µg/kg per minute). Both agents induced a renal vasodilation and increased RBF to a similar extent. However, levosimendan treated patients experienced an increase in GFR (22%, P=.012). In contrast, dobutamine treated patients experienced no improvement in GFR.
Researchers said the study is the first to evaluate the differential effects of levosimendan and a catecholamine on measured RBF, GFR and renal oxygenation in patients with HF and renal dysfunction.
Lannemyr L, et al. J Am Heart Assoc. 2018;doi:10.1161/JAHA.117.008455.
Disclosures: Lannemyr reports no relevant financial disclosures. The work was supported by Swedish State Support for Clinical Research, the Swedish Heart-Lung Foundation and the Gothenburg Medical Society. Please see the study for all other authors’ relevant financial disclosures.