Renal effects of levosimendan: A consensus report

Mehmet B. Yilmaz, Elena Grossini, José C. Silva Cardoso, István Édes, Francesco Fedele, Piero Pollesello, Matti Kivikko, Veli Pekka Harjola, Julia Hasslacher, Alexandre Mebazaa, Andrea Morelli, Jos Le Noble, Anders Oldner, Ignacio Oulego Erroz, John T. Parissis, Alexander Parkhomenko, Gerhard Poelzl, Sebastian Rehberg, Sven Erik Ricksten, Luís M. Rodríguez FernándezMarkku Salmenperä, Mervyn Singer, Sascha Treskatsch, Bojan Vrtovec, Gerhard Wikström

Research output: Contribution to journalReview article

36 Citations (Scopus)


Renal dysfunction is common in clinical settings in which cardiac function is compromised such as heart failure, cardiac surgery or sepsis, and is associated with high morbidity and mortality. Levosimendan is a calcium sensitizer and potassium channel opener used in the treatment of acute heart failure. This review describes the effects of the inodilator levosimendan on renal function. A panel of 25 scientists and clinicians from 15 European countries (Austria, Finland, France, Hungary, Germany, Greece, Italy, Portugal, the Netherlands, Slovenia, Spain, Sweden, Turkey, the United Kingdom, and Ukraine) convened and reached a consensus on the current interpretation of the renal effects of levosimendan described both in non-clinical research and in clinical study reports. Most reports on the effect of levosimendan indicate an improvement of renal function in heart failure, sepsis and cardiac surgery settings. However, caution should be applied as study designs differed from randomized, controlled studies to uncontrolled ones. Importantly, in the largest HF study (REVIVE I and II) no significant changes in the renal function were detected. As it regards themechanism of action, the opening of mitochondrial KATP channels by levosimendan is involved through a preconditioning effect. There is a strong rationale for randomized controlled trials seeking beneficial renal effects of levosimendan. As an example, a study is shortly to commence to assess the role of levosimendan for the prevention of acute organ dysfunction in sepsis (LeoPARDS).

Original languageEnglish
Pages (from-to)581-590
Number of pages10
JournalCardiovascular Drugs and Therapy
Issue number6
Publication statusPublished - Dec 1 2013


  • Levosimendan
  • Renal dysfunction

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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  • Cite this

    Yilmaz, M. B., Grossini, E., Silva Cardoso, J. C., Édes, I., Fedele, F., Pollesello, P., Kivikko, M., Harjola, V. P., Hasslacher, J., Mebazaa, A., Morelli, A., Le Noble, J., Oldner, A., Erroz, I. O., Parissis, J. T., Parkhomenko, A., Poelzl, G., Rehberg, S., Ricksten, S. E., ... Wikström, G. (2013). Renal effects of levosimendan: A consensus report. Cardiovascular Drugs and Therapy, 27(6), 581-590.