Cardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practice
Abstract Background The association between cardiac complications, such as heart failure (HF), and chronic kidney disease (CKD) is well known. In this study, we examined the effectiveness and safety of treatment with neprilysin inhibition in patients with advanced chronic kidney disease (stage 3b-4)...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-022-02919-z |
| _version_ | 1811188890174750720 |
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| author | María Dolores Martínez-Esteban Teresa Vázquez-Sánchez Rafael Pozo-Álvarez Alicia Moreno-Ortiz Juana Alonso-Titos Guillermo Martín-Reyes Pedro Ruiz-Esteban Daniel Gaitán-Román Domingo Hernández |
| author_facet | María Dolores Martínez-Esteban Teresa Vázquez-Sánchez Rafael Pozo-Álvarez Alicia Moreno-Ortiz Juana Alonso-Titos Guillermo Martín-Reyes Pedro Ruiz-Esteban Daniel Gaitán-Román Domingo Hernández |
| author_sort | María Dolores Martínez-Esteban |
| collection | DOAJ |
| description | Abstract Background The association between cardiac complications, such as heart failure (HF), and chronic kidney disease (CKD) is well known. In this study, we examined the effectiveness and safety of treatment with neprilysin inhibition in patients with advanced chronic kidney disease (stage 3b-4). Methods This single-centre, longitudinal, retrospective study of 31 months duration involved consecutive patients with CKD and HF with a reduced ejection fraction (HFrEF) who started treatment with sacubitril/valsartan. Glomerular filtration rate (GFR), cardiovascular risk factors, proteinuria, potassium, echocardiographic parameters and admissions for heart failure were analysed. Results The study comprised 25 patients with a median age of 73.2 ± 5.9 years. The most frequent aetiology of heart failure was ischemic heart disease. The median GFR was 29.4 ± 8.3 ml/min/1.73 m2 and the left ventricular ejection fraction (LVEF) 36.4 ± 8.9%. The GFR improved after initiating the treatment (F = 3.396, p = 0.019), as did the LVEF at one year of follow-up (p = 0.018). The number of visits to the emergency department for heart failure was also reduced. No patients needed to start renal replacement therapy. Conclusions This study shows that sacubitril/valsartan may play a beneficial role in patients who have advanced CKD and HFrEF, with a satisfactory safety profile. |
| first_indexed | 2024-04-11T14:26:40Z |
| format | Article |
| id | doaj.art-93afe7f86d9145e3ac4f4177b11cd6c5 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-11T14:26:40Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-93afe7f86d9145e3ac4f4177b11cd6c52022-12-22T04:18:51ZengBMCBMC Nephrology1471-23692022-08-012311710.1186/s12882-022-02919-zCardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practiceMaría Dolores Martínez-Esteban0Teresa Vázquez-Sánchez1Rafael Pozo-Álvarez2Alicia Moreno-Ortiz3Juana Alonso-Titos4Guillermo Martín-Reyes5Pedro Ruiz-Esteban6Daniel Gaitán-Román7Domingo Hernández8Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012)Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012)Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012)Cardiology Department, Hospital Regional Universitario de MálagaNephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012)Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012)Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012)Cardiology Department, Hospital Regional Universitario de MálagaNephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012)Abstract Background The association between cardiac complications, such as heart failure (HF), and chronic kidney disease (CKD) is well known. In this study, we examined the effectiveness and safety of treatment with neprilysin inhibition in patients with advanced chronic kidney disease (stage 3b-4). Methods This single-centre, longitudinal, retrospective study of 31 months duration involved consecutive patients with CKD and HF with a reduced ejection fraction (HFrEF) who started treatment with sacubitril/valsartan. Glomerular filtration rate (GFR), cardiovascular risk factors, proteinuria, potassium, echocardiographic parameters and admissions for heart failure were analysed. Results The study comprised 25 patients with a median age of 73.2 ± 5.9 years. The most frequent aetiology of heart failure was ischemic heart disease. The median GFR was 29.4 ± 8.3 ml/min/1.73 m2 and the left ventricular ejection fraction (LVEF) 36.4 ± 8.9%. The GFR improved after initiating the treatment (F = 3.396, p = 0.019), as did the LVEF at one year of follow-up (p = 0.018). The number of visits to the emergency department for heart failure was also reduced. No patients needed to start renal replacement therapy. Conclusions This study shows that sacubitril/valsartan may play a beneficial role in patients who have advanced CKD and HFrEF, with a satisfactory safety profile.https://doi.org/10.1186/s12882-022-02919-zChronic kidney diseaseHeart failureReduced ejection fractionNeprilysin inhibitorGlomerular filtration rate |
| spellingShingle | María Dolores Martínez-Esteban Teresa Vázquez-Sánchez Rafael Pozo-Álvarez Alicia Moreno-Ortiz Juana Alonso-Titos Guillermo Martín-Reyes Pedro Ruiz-Esteban Daniel Gaitán-Román Domingo Hernández Cardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practice BMC Nephrology Chronic kidney disease Heart failure Reduced ejection fraction Neprilysin inhibitor Glomerular filtration rate |
| title | Cardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practice |
| title_full | Cardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practice |
| title_fullStr | Cardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practice |
| title_full_unstemmed | Cardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practice |
| title_short | Cardio-renal benefits of sacubitril/valsartan in patients with advanced chronic kidney disease: experience in daily clinical practice |
| title_sort | cardio renal benefits of sacubitril valsartan in patients with advanced chronic kidney disease experience in daily clinical practice |
| topic | Chronic kidney disease Heart failure Reduced ejection fraction Neprilysin inhibitor Glomerular filtration rate |
| url | https://doi.org/10.1186/s12882-022-02919-z |
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