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Critical Care

Open Access

Effects of levosimendan on renal function in septic shock: a case–control study

  • A Morelli1,
  • C Etmer2,
  • S Rehberg2,
  • A Orecchioni1,
  • N Cannuovacciuolo1,
  • B Bollen Pinto2,
  • M Lange2,
  • H Van Aken2,
  • A Donati3,
  • P Pietropaoli1 and
  • M Westphal2
Critical Care200913(Suppl 1):P170

Published: 13 March 2009


Renal FunctionGlomerular Filtration RateSeptic ShockLevosimendanControl Cohort


Nonhemodynamic mechanisms of cell injury might play a role in the loss of glomerular filtration rate during sepsis [1]. We hypothesized that levosimendan may positively affect renal function by a combination of systemic and regional hemodynamic, anti-inflammatory and anti-apoptotic effects. We therefore performed a case–control study to investigate the effects of levosimendan on creatinine clearance in patients with septic shock.


Ninety-nine septic shock patients received levosimendan (0.2 μg/kg/min for 24 hours) within the first 36 hours following onset of septic shock. For each study patient, a control subject from a group of patients with septic shock of an institutional database was matched for Simplified Acute Physiology Score II, baseline creatinine concentration, delay from shock onset, age, and gender. Serum creatinine concentrations were analyzed just before the start of the 24-hour period of levosimendan infusion (baseline) and 96 hours after levosimendan had been initiated. The glomerular filtration rate was estimated by applying the Cockcroft–Gault formula.


Compared with the control cohort, levosimendan significantly increased the glomerular filtration rate after 96 hours (62 ± 46 vs. 50 ± 33 ml/min, P < 0.05). In addition, the maximum serum creatinine concentration was lower in the levosimendan group (2.2 ± 1.3 vs. 2.6 ± 2 mg/dl, P < 0.05 vs. control) during the 96-hour study period.


The present data suggest that levosimendan may improve renal function in patients with septic shock.

Authors’ Affiliations

University of Rome, Italy
University of Muenster, Germany
Marche Polytechnique University, Ancona, Italy


  1. Wan L, et al.: Pathophysiology of septic acute kidney injury: what do we really know? Crit Care Med 2008, 36: S198-S203. 10.1097/CCM.0b013e318168ccd5PubMedView ArticleGoogle Scholar


© Morelli et al; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.