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Kidney Week

Abstract: PO1805

Renal Outcomes and Safety of Angiotensin Receptor Neprilysin Inhibitors in Patients with Heart Failure: A Meta-Analysis

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Abou arkoub, Rima Nazih, McGill University Health Centre, Montreal, Quebec, Canada
  • Mavrakanas, Thomas, McGill University Health Centre, Montreal, Quebec, Canada
  • Bergeron, Amy, McGill University Health Centre Glen Site McConnell Resource Centre Medical Library, Montreal, Quebec, Canada
  • Sharma, Abhinav, McGill University Health Centre, Montreal, Quebec, Canada
  • Alam, Ahsan, McGill University Health Centre, Montreal, Quebec, Canada
Background

Angiotensin receptor neprilysin inhibitors (ARNIs) are an effective treatment for heart failure. However, their safety profile compared with angiotensin converting enzyme-inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) with respect to renal outcomes has not been clearly established.

Methods

We conducted a literature search of MEDLINE, Cochrane library, Embase, and clinical trials registries using relevant search terms (last search date May 7, 2021). The primary renal outcome was kidney function decline and the safety outcome was hyperkalemia. Only studies with at least 12 weeks of follow up were included in the renal outcome analysis to better capture CKD.

Results

Ten randomized controlled trials were eligible for inclusion (n=22,174 participants). ARNIs were associated with a lower risk of kidney function decline compared with ACEIs or ARBs: RR 0.65 (95%CI 0.53-0.81). The risk of hyperkalemia was similar in both treatment groups: RR 0.96 (95%CI 0.81-1.13).

Conclusion

ARNI use in patients with heart failure is associated with a lower risk of kidney function decline and a similar risk of hyperkalemia compared to ACEIs or ARBs.

Fig 1. PRISMA Flow Diagram

Fig 2. Forest plots