Kidney Week

Abstract: PO2036

A Meta-Analysis Evaluating the Effect of Sacubitril-Valsartan on Renal Function in Heart Failure Patients

Session Information

• Clinical Pharmacology, Pharmacokinetics, and Drug Toxicity in Kidney Diseases
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

• 1800 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

Authors

• Seetharam, Karthik, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Karthik Seetharam, MD

• Shah, Jilan, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Jilan Shah,

• Yenugadhati, Vamsi, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Vamsi Yenugadhati,

• Kumar, Kelash, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Kelash Kumar,

• Orris, Maxine, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Maxine Orris,

• Hejmadi, Prabhu, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Prabhu Hejmadi,

• Mir, Tanveer, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Tanveer Mir,

• Asti, Deepak, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Deepak Asti,

• Chawla, Preety, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Preety Chawla,

• Punukollu, Gopi, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Gopi Punukollu,

• Zapata, Carlos M., Wyckoff Heights Medical Center, Brooklyn, New York, United States

Carlos M. Zapata,

• Mercado, Luis, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Luis Mercado,

• Mir, Pervez, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Pervez Mir,

• Patel, Priyank, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Priyank Patel,

• Bhatt, Utpal, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Utpal Bhatt,

• Mahankali, Bhavani D., Wyckoff Heights Medical Center, Brooklyn, New York, United States

Bhavani D. Mahankali,

• Bhat, Premila, Wyckoff Heights Medical Center, Brooklyn, New York, United States

Premila Bhat,

Background

Cardiorenal syndrome (CRS) has been associated with increased morbidity and mortality in heart failure (HF). Sacubitril-Valsartan is the first- in-class angiotensin receptor- neprilysin inhibitor which has been found to reduce all-cause mortality in HF with reduced left ventricular ejection fraction. The effect of sacubitril-valsartan on renal outcomes is unknown. This meta-analysis analyzes recent studies comparing renal outcomes between sacubitril-valsartan and RAS inhibitors in heart failure patients.

Methods

We performed a comprehensive literature search for all eligible studies comparing Sacubitril-Valsartan and RAS inhibitors in Pubmed, EMBASE, SCOPUS, and google scholar. Only recent clinical trials were included. All retrospective studies were excluded. Clinical outcomes comprised of all-causes mortality and renal complications.

Results

5 Randomized clinical trials (RCT) were deemed eligible, which consisted of 7325 sacubitril- valsartan patients and 7333 RAS inhibitor patients. Meta-analysis confirmed that Sacubitril-valsartan was associated with reduced all-cause mortality (OR= 0.87, p = .002). A lower risk of worsening renal function, defined as increase in ≥ 0.3 mg/dl in serum creatinine compared with the value on admission (OR = .81, p = 0.008), was seen in the sacubitril-valsartan group. Hyperkalemia, defined as potassium greater than 6 mil/L was lower in the sacubitril-valsartan group (OR= 0.75, p = 0.0007) in comparison to RAS inhibitors. Howerver, sacubitril-valsartan had a higher risk of symptomatic hypotension (OR = 156, p < 0.00001). There was no observed statistically significant differences in angioedema.

Conclusion

Sacubitril-Valsartan reduces the risk of all- cause mortality, diminished renal function, and hyperkalemia compared with RAS inhibitors. Further evaluation is required.