title: Perioperative levosimendan therapy is associated with a lower incidence of acute kidney injury after cardiac surgery: a meta-analysis.
abstract: OBJECTIVE
  Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. Limited data are available on its renal-protective effect, and no statistically significant effects have been found. A meta-analysis was conducted for randomized studies to show whether perioperative levosimendan use could reduce acute kidney injury (AKI) in patients undergoing cardiac surgery.
  
  
  METHODS
  BioMed Central, PubMed EMBASE, and the Cochrane Central Register of Controlled Trials were searched for pertinent studies.
  
  
  METHODS
  Randomized trials that compared levosimendan versus placebo or any other control in cardiac surgery with data on AKI were included. Exclusion criteria were duplicate publications, nonadult studies, oral administration of levosimendan, and studies with no data on AKI.
  
  
  METHODS
  Study endpoints, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted.
  
  
  RESULTS
  Data from 529 patients in 5 randomized trials were analyzed. The analysis showed that levosimendan decreased postoperative incidence of AKI in the levosimendan group.
  
  
  CONCLUSIONS
  This analysis suggests that levosimendan might reduce renal injury in adult patients undergoing cardiac surgery. More prospective randomized studies are needed to further demonstrate the benefits of levosimendan on renal protection in cardiac surgery.
authors.affiliation: *Department of Cardiac Surgery, Qilu Hospital, Shandong University, Jinnan, China; and †Department of Cardiac Surgery, Qingdao Municipal Hospital, Qingdao, China.
authors.forename: Zhao-Zhuo
authors.initials: ZZ
authors.lastname: Niu
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Wu
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Sun
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Hou
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Chi
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D015994:Incidence; D019990:Perioperative Care / Q000379:methods; D011724:Pyridazines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000077464:Simendan
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan