Acute renal failure secondary to milrinone in a patient with cardiac amyloidosis

Saab, Georges; Mindel, Graeme; Ewald, Gregory A.; Vijayan, Anitha

doi:10.1053/ajkd.2002.34552

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Fourteen therapies (12 pts.) were administered for <24 hours (11.8 ± 6.6; range [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], and 77 therapies (75 pts.) were administered for ≥24 hours (7.7 ± 11.2 days; range 1-60).…”

Section: Resultsmentioning

confidence: 99%

“…20 The patient required temporary renal replacement therapy, and his milrinone-induced hypotension responded best to a low-dose vasopressin infusion. Concomitant treatment with an ACE inhibitor had likely contributed to the hypotension and ARF in that patient.…”

Section: Discussionmentioning

confidence: 99%

“…Although a mild elevation in SCr has been described in the setting of milrinone-induced hypotension, we could find only one case of oliguric ARF secondary to milrinone therapy in a patient with cardiac amyloidosis who was also receiving ACE inhibitor therapy. 20 The patient required temporary renal replacement therapy, and his milrinone-induced hypotension responded best to a low-dose vasopressin infusion. Concomitant treatment with an ACE inhibitor had likely contributed to the hypotension and ARF in that patient.…”

Section: Discussionmentioning

confidence: 99%

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Incidence of Acute Renal Failure Associated with Milrinone

Amin

Bastani

2005

Journal of Pharmacy Technology

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Background: Milrinone is a phosphodiesterase type III inhibitor with positive inotropic and vasodilatory effects used in patients with severe congestive heart failure (CHF). Objectives:To determine the incidence rate of acute renal failure (ARF) associated with milrinone therapy.Methods: Medical records of 116 patients with cardiomyopathy/severe CHF who Twenty-nine patients were excluded, resulting in 87 patients, 4 of whom received milrinone twice.Results: During a 3-year period, 11 of 91 milrinone therapies became complicated with ARF (incidence 12%). The patients' age (mean ± SD) was 52.3 ± 13.6 years, baseline serum creatinine (SCr) was 1.6 ± 1.0 mg/dL, milrinone dose was 0.47 ± 0.16 µg/kg/min, and mean duration of therapy was 6.5 ± 10.6 days. Fourteen treatments were <24 hours, 2 (14%) of which were complicated with ARF; of the remaining 77 treatments (≥24 h), 9 (11.7%) were complicated with ARF. Their peak SCr was 3.2 ± 1.5 mg/dL and time to peak SCr was 4.9 ± 2.8 days. There was no significant difference in the incidence of ARF in patients who received therapy for <24 hours versus ≥24 hours; in the prevalence rate of diabetes mellitus, hypertension, coronary artery disease; or in baseline SCr, milrinone dose, and duration of therapy between patients who did and did not develop ARF. Conclusions:We found a 12% incidence of ARF in patients receiving milrinone therapy for severe CHF, which in the absence of an appropriate control group could be the aggregate effects of milrinone therapy and severe CHF.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Incidence of Acute Renal Failure Associated with Milrinone

Amin

Bastani

2005

Journal of Pharmacy Technology

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“…Catecholamines (epinephrine, norepinephrine, dopamine, and dobutamine) and phosphodiesterase inhibitor (milrinone) are the traditional prophylactic and therapeutic medications. However, these drugs are associated with considerable side effects (11,12). Levosimendan is a novel inotropic drug that enhances myocardial contractility through increasing the sensitivity of calcium ion to cardiomyocytes (13).…”

Section: Introductionmentioning

confidence: 99%

Effect of Prophylactic Levosimendan on All-Cause Mortality in Pediatric Patients Undergoing Cardiac Surgery—An Updated Systematic Review and Meta-Analysis

Wang

Luo

et al. 2020

Front. Pediatr.

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Background: Levosimendan, a calcium sensitizer, enhances the myocardial function by generating more energy-efficient myocardial contractility than that achieved through adrenergic stimulation with catecholamines. We conducted this meta-analysis to primarily investigate the effects of levosimendan on all-cause mortality in pediatric patients undergoing cardiac surgery under cardiopulmonary bypass. Methods: The databases of Pubmed, Embase, and Cochrane Library were searched till 21st March 2020. The eligible criteria were participants with age<18 year and undergoing cardiac surgery for congenital heart disease (CHD), and studies of comparison between levosimendan and placebo or other inotropes. Stata version 12.0 was used to perform statistical analyses. Results: Six randomized controlled trials (RCTs) and 1 case-control trial (CCT) including 436 patients were included. The results showed that levosimendan did not significantly decrease all-cause mortality compared with control drugs (and placebo) in children undergoing cardiac surgery (P = 0.403). Perioperative prophylactic levosimendan administration strikingly decreased the low cardiac output syndrome (LCOS) incidence (P = 0.016) but did not significantly reduce acute kidney injury (AKI) incidence (P = 0.251) and shorten mechanical ventilation and ICU stay time compared with other inotropes and placebo by analyzing the included literatures [mechanical ventilation (or intubation) time: P = 0.188; ICU stay time: P = 0.620]. Conclusions: Compared with other inotropes and placebo, perioperative prophylactic administration of levosimendan did not decrease the rates of mortality and AKI and shorten the time of mechanical ventilation (or intubation) and ICU stay but demonstrated a significant reduction in LCOS incidence after corrective surgery in pediatric patients for CHD. Due to limited number of included studies, the current data were insufficient to make the conclusions.

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