Clinical relevance of transient worsening renal function after initiation of sacubitril/valsartan.

Current Medical Research and Opinion
Daniele MasaroneGiuseppe Pacileo

Abstract

The worsening of renal function after the start of valsartan therapy is relatively common in clinical practice. However, few data are available on the incidence of worsening renal function after the beginning of therapy with sacubitril/valsartan. We retrospectively enrolled 202 outpatients with HFrEF that started therapy with sacubitril/valsartan to evaluate the prevalence of worsening renal function and its clinical significance. At 1 month, a worsening renal function (defined as a > 20% decrease in eGFR occurring after 1 month of ARNi therapy) was found in 68 patients (33%), however after a mean follow-up of 650 ± 80 days, Kaplan-Meier analysis showed no significant in terms of HF-related deaths, HF-related hospitalizations, and the need for renal replacement therapy (25.2 vs. 23.6%; p = .812). In addition, the renal function recovered in patients with early WRF at 3 months (62 + 9.3 ml/min/1.73 m2 vs. 63 ± 13.8 ml/min/1.73 m2; p < .05), with an improvement in estimated glomerular filtration rate at 1 year compared with baseline value (62 ± 9.3 ml/min/1.73 m2 vs. 69 ± 8.6 ml/min/1.73 m2; p < .01). WRF occurs in nearly 30% of HFrEF patients without impacting clinical outcomes; HF specialists should be aware of these changes to...Continue Reading

References

Apr 16, 2018·JACC. Heart Failure·Kevin DammanJohn J V McMurray
Feb 12, 2019·European Journal of Heart Failure·Orly VardenyScott D Solomon
Apr 28, 2019·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Borja QuirogaVicente Álvarez-Chiva
May 31, 2019·Internal and Emergency Medicine·Francesco SpannellaRiccardo Sarzani

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