Effects of Levosimendan on Renal Function in Patients Undergoing Coronary Artery Surgery

Objectives: To evaluate the effect of levosimendan on postoperative renal function in patients with compromised heart function undergoing on-pump coronary artery bypass graft surgery. Design: A prospective, randomized, placebo-controlled, double-blind substudy. Setting: Cardiothoracic surgery, anesthesiology, and intensive care units at 2 university hospitals. Participants: Sixty patients with left ventricular ejection fraction <= 50% were randomized into 2 parallel treatment groups. Interventions: Levosimendan or placebo was started after the induction of anesthesia with a 12-mu g/kg bolus in 10 minutes followed by the infusion of 0.2 mu g/kg/min for the next 23 hours and 50 minutes. Measurements and Results: Serum cystatin C and plasma creatinine were measured at baseline; at 6 and 24 hours after declamping the aorta; and on the 1st, 2nd, and 5th postoperative days. Urine N-acetyl-beta-glucosaminidase (U-NAG) was measured at baseline and at 6 and 24 hours after declamping of the aorta. Renal function was estimated with calculated glomerular filtration rate (eGFR). The changes in plasma creatinine, serum cystatin C, and urine NAG were not significant among the placebo and the levosimendan groups at any of the measuring points. Conclusions: After coronary artery surgery, levosimendan did not have a significant influence on the kidney function measured with these specific kidney markers. (C) 2012 Elsevier Inc. All rights reserved.