Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal Dysfunction

Heart failure (HF) and renal dysfunction often coexist and interact in many complex and bidirectional pathways, leading to detrimental effects on patient outcomes. The treatment of HF patients with renal dysfunction presents a significant clinical challenge. Interestingly, sacubitril/valsartan, an a...

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Main Authors: Xiaogang Zhu, Xialing Li, Lingxuan Zhu, Zichuan Tong, Xiuying Xu
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Cardiovascular Therapeutics
Online Access:http://dx.doi.org/10.1155/2024/6231184
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author Xiaogang Zhu
Xialing Li
Lingxuan Zhu
Zichuan Tong
Xiuying Xu
author_facet Xiaogang Zhu
Xialing Li
Lingxuan Zhu
Zichuan Tong
Xiuying Xu
author_sort Xiaogang Zhu
collection DOAJ
description Heart failure (HF) and renal dysfunction often coexist and interact in many complex and bidirectional pathways, leading to detrimental effects on patient outcomes. The treatment of HF patients with renal dysfunction presents a significant clinical challenge. Interestingly, sacubitril/valsartan, an angiotensin receptor–neprilysin inhibitor (ARNI), may have beneficial effects on cardiac and renal outcomes in patients with HF with reduced ejection fraction, particularly by slowing the rate of decrease in the estimated glomerular filtration rate compared to a single angiotensin–converting enzyme inhibitor. Recently, more reports have emphasized the renal protection of sacubitril/valsartan in patients with HF. In HF patients with renal dysfunction, however, there is no strong evidence supporting the use of sacubitril/valsartan to reduce the absolute risk of hyperkalemia and worsening renal function; therefore, the administration of ARNI requires a careful balance between the benefits and risks. Furthermore, the lack of evidence-based management highlights the importance of an individualized approach based on published experience and multidisciplinary collaborations, as well as underlines the need for in-depth studies investigating the underlying mechanisms in cardiorenal interactions with a focus on treatments.
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spelling doaj-art-09a47fa8fd0447669ace439f55aa65212025-08-20T03:17:31ZengWileyCardiovascular Therapeutics1755-59222024-01-01202410.1155/2024/6231184Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal DysfunctionXiaogang Zhu0Xialing Li1Lingxuan Zhu2Zichuan Tong3Xiuying Xu4Department of CardiologyDepartment of CardiologySchool of Data ScienceDepartment of CardiologyDepartment of CardiologyHeart failure (HF) and renal dysfunction often coexist and interact in many complex and bidirectional pathways, leading to detrimental effects on patient outcomes. The treatment of HF patients with renal dysfunction presents a significant clinical challenge. Interestingly, sacubitril/valsartan, an angiotensin receptor–neprilysin inhibitor (ARNI), may have beneficial effects on cardiac and renal outcomes in patients with HF with reduced ejection fraction, particularly by slowing the rate of decrease in the estimated glomerular filtration rate compared to a single angiotensin–converting enzyme inhibitor. Recently, more reports have emphasized the renal protection of sacubitril/valsartan in patients with HF. In HF patients with renal dysfunction, however, there is no strong evidence supporting the use of sacubitril/valsartan to reduce the absolute risk of hyperkalemia and worsening renal function; therefore, the administration of ARNI requires a careful balance between the benefits and risks. Furthermore, the lack of evidence-based management highlights the importance of an individualized approach based on published experience and multidisciplinary collaborations, as well as underlines the need for in-depth studies investigating the underlying mechanisms in cardiorenal interactions with a focus on treatments.http://dx.doi.org/10.1155/2024/6231184
spellingShingle Xiaogang Zhu
Xialing Li
Lingxuan Zhu
Zichuan Tong
Xiuying Xu
Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal Dysfunction
Cardiovascular Therapeutics
title Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal Dysfunction
title_full Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal Dysfunction
title_fullStr Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal Dysfunction
title_full_unstemmed Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal Dysfunction
title_short Angiotensin Receptor–Neprilysin Inhibitor in Heart Failure Patients With Renal Dysfunction
title_sort angiotensin receptor neprilysin inhibitor in heart failure patients with renal dysfunction
url http://dx.doi.org/10.1155/2024/6231184
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AT zichuantong angiotensinreceptorneprilysininhibitorinheartfailurepatientswithrenaldysfunction
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