Administration of Enoximone for the Optimization of Renal Function in Cardiac Surgery

In this multicenter prospective observational study, the authors evaluated the association between perioperative enoximone administration and renal outcomes in 237 adults undergoing on-pump cardiac surgery; 110 (46.4 percent) received enoximone. Propensity score matching yielded 72 treated patients and 72 controls. Although estimated glomerular filtration rate (eGFR) did not differ on postoperative days two or seven, enoximone was associated with greater improvement at 30 days (+8.1 vs −3.7 mL/min/1.73 m²; p<0.001). Enoximone independently predicted 30-day eGFR improvement (β=+10.65; p<0.001) and improvement in Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) stage (β=−0.26; p=0.002). Treated patients also required fewer additional inotropes (4.2 percent vs 26.4 percent; p<0.001) and had shorter hospital stays (13.2 vs 17.1 days; p=0.008). The authors conclude that perioperative enoximone was associated with improved renal function and shorter hospitalization, while emphasizing that further studies are required to confirm a potential renoprotective effect.