ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2036

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

Session Information

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

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

Authors

  • Seetharam, Karthik, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Shah, Jilan, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Yenugadhati, Vamsi, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Kumar, Kelash, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Orris, Maxine, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Hejmadi, Prabhu, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Mir, Tanveer, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Asti, Deepak, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Chawla, Preety, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Punukollu, Gopi, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Zapata, Carlos M., Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Mercado, Luis, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Mir, Pervez, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Patel, Priyank, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Bhatt, Utpal, Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Mahankali, Bhavani D., Wyckoff Heights Medical Center, Brooklyn, New York, United States
  • Bhat, Premila, Wyckoff Heights Medical Center, Brooklyn, New York, United States
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.