Effects of sacubitril-valsartan in patients undergoing maintenance dialysis
AbstractObjectives Data on angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril-valsartan (SV) in patients undergoing maintenance dialysis is scarce. Our study aimed to investigate the effect of SV on patients undergoing dialysis.Methods We retrospectively reviewed the data of end-stage kidne...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2222841 |
| _version_ | 1797658490379960320 |
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| author | Ying Ding Li Wan Zhou-cang Zhang Qing-hua Yang Jia-xiang Ding Zhen Qu Feng Yu |
| author_facet | Ying Ding Li Wan Zhou-cang Zhang Qing-hua Yang Jia-xiang Ding Zhen Qu Feng Yu |
| author_sort | Ying Ding |
| collection | DOAJ |
| description | AbstractObjectives Data on angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril-valsartan (SV) in patients undergoing maintenance dialysis is scarce. Our study aimed to investigate the effect of SV on patients undergoing dialysis.Methods We retrospectively reviewed the data of end-stage kidney disease (ESRD) patients undergoing either peritoneal dialysis (PD) or hemodialysis (HD) in our center. A total of 51 patients receiving SV treatment were enrolled in the SV group. Another 51 age and sex-matched patients on dialysis without SV treatment were selected as the control group. All the patients were regularly followed up in the dialysis clinic. Their clinical, biochemical, and echocardiographic parameters were all recorded at baseline and during follow-up. The effect and safety of SV were further analyzed.Results A total of 102 ESRD patients on dialysis (51 patients in the SV group and 51 patients in the control group) were finally enrolled. The median follow-up time was 349 days (interquartile range [IQR]: 217–535 days). The level of B-type natriuretic peptide (BNP) (median [IQR] before and after SV treatment: 596.35 pg/ml [190.6–1714.85] vs. 188.7 pg/ml [83.34–600.35], p < 0.001) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) (median [IQR]: 6316.00 pg/ml [4552.00–28598.00] vs. 5074.00 pg/ml [2229.00–9851.00], p = 0.022) were significantly decreased after treatment with SV. The variant rate of left ventricular ejection fraction (LVEF) was significantly higher in the SV group compared to the control group, especially in the PD subgroup. No significant difference was found in other echocardiographic parameters between SV and control group. Subgroup analysis of the PD group showed an increase in daily PD ultrafiltration (median [IQR]: 400 ml/d [200-500] vs. 500 ml/d [200–850], p = 0.114) after SV treatment. Variant rate of overhydration (OH) measured by the body composition monitor (BCM) of the SV group were significantly different from the control group (median [IQR]: −13.13% [−42.85%–27.84%] vs. 0% [−17.95%–53.85%], p = 0.049). The rate of hyperkalemia was slightly higher but without significant difference before and after the introduction of SV (19.6% vs. 27.5%, p = 0.350). No event of hypotension and angioedema were observed.Conclusions SV might have a cardio-protective role in ESRD patients undergoing dialysis, especially in PD patients. Serum potassium should be monitored during the treatment. |
| first_indexed | 2024-03-11T17:59:42Z |
| format | Article |
| id | doaj.art-215feebabe054c7b9b054c8639713b3a |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-03-11T17:59:42Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-215feebabe054c7b9b054c8639713b3a2023-10-17T09:23:23ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2222841Effects of sacubitril-valsartan in patients undergoing maintenance dialysisYing Ding0Li Wan1Zhou-cang Zhang2Qing-hua Yang3Jia-xiang Ding4Zhen Qu5Feng Yu6Department of Nephrology, Peking University International Hospital, Beijing, PR. ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, PR. ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, PR. ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, PR. ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, PR. ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, PR. ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, PR. ChinaAbstractObjectives Data on angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril-valsartan (SV) in patients undergoing maintenance dialysis is scarce. Our study aimed to investigate the effect of SV on patients undergoing dialysis.Methods We retrospectively reviewed the data of end-stage kidney disease (ESRD) patients undergoing either peritoneal dialysis (PD) or hemodialysis (HD) in our center. A total of 51 patients receiving SV treatment were enrolled in the SV group. Another 51 age and sex-matched patients on dialysis without SV treatment were selected as the control group. All the patients were regularly followed up in the dialysis clinic. Their clinical, biochemical, and echocardiographic parameters were all recorded at baseline and during follow-up. The effect and safety of SV were further analyzed.Results A total of 102 ESRD patients on dialysis (51 patients in the SV group and 51 patients in the control group) were finally enrolled. The median follow-up time was 349 days (interquartile range [IQR]: 217–535 days). The level of B-type natriuretic peptide (BNP) (median [IQR] before and after SV treatment: 596.35 pg/ml [190.6–1714.85] vs. 188.7 pg/ml [83.34–600.35], p < 0.001) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) (median [IQR]: 6316.00 pg/ml [4552.00–28598.00] vs. 5074.00 pg/ml [2229.00–9851.00], p = 0.022) were significantly decreased after treatment with SV. The variant rate of left ventricular ejection fraction (LVEF) was significantly higher in the SV group compared to the control group, especially in the PD subgroup. No significant difference was found in other echocardiographic parameters between SV and control group. Subgroup analysis of the PD group showed an increase in daily PD ultrafiltration (median [IQR]: 400 ml/d [200-500] vs. 500 ml/d [200–850], p = 0.114) after SV treatment. Variant rate of overhydration (OH) measured by the body composition monitor (BCM) of the SV group were significantly different from the control group (median [IQR]: −13.13% [−42.85%–27.84%] vs. 0% [−17.95%–53.85%], p = 0.049). The rate of hyperkalemia was slightly higher but without significant difference before and after the introduction of SV (19.6% vs. 27.5%, p = 0.350). No event of hypotension and angioedema were observed.Conclusions SV might have a cardio-protective role in ESRD patients undergoing dialysis, especially in PD patients. Serum potassium should be monitored during the treatment.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2222841Sacubitril-valsartanangiotensin receptor-neprilysin inhibitordialysisend-stage renal disease |
| spellingShingle | Ying Ding Li Wan Zhou-cang Zhang Qing-hua Yang Jia-xiang Ding Zhen Qu Feng Yu Effects of sacubitril-valsartan in patients undergoing maintenance dialysis Renal Failure Sacubitril-valsartan angiotensin receptor-neprilysin inhibitor dialysis end-stage renal disease |
| title | Effects of sacubitril-valsartan in patients undergoing maintenance dialysis |
| title_full | Effects of sacubitril-valsartan in patients undergoing maintenance dialysis |
| title_fullStr | Effects of sacubitril-valsartan in patients undergoing maintenance dialysis |
| title_full_unstemmed | Effects of sacubitril-valsartan in patients undergoing maintenance dialysis |
| title_short | Effects of sacubitril-valsartan in patients undergoing maintenance dialysis |
| title_sort | effects of sacubitril valsartan in patients undergoing maintenance dialysis |
| topic | Sacubitril-valsartan angiotensin receptor-neprilysin inhibitor dialysis end-stage renal disease |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2222841 |
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