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Abstract: SA-PO506

Sacubitril/Valsartan Improves Cardiac Function in Dialysis Patients

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Armaly, Zaher, Nazareth Hospital EMMS, Nazareth, Israel

Heart failure is a common disease characterized by activation of adverse neurohormonal systems and high mortality and mortality rate. Noteworthy, cardiovascular diseases are well known complication of CKD, especially in ESRD, where dialysis patients are 7- 8 times more likely to encounter cardiac arrest than the general population. Sacubitril/Valsartan (Sac/Val) is a dual inhibitor/blocker of neprilysin and angiotensin II receptor, which exert cardioprotective effects among patients with reduced and preserved ejection fraction (HFrEF & HFpEF). Unfortunately, the drug is not approved for subjects with advanced CKD and dialysis patients due to safety concern. The current study examined cardiac and renal effects of Sac/Val in dialysis patients.


The study was approved by the Nazareth Hospital EMMS Human Research Review Committee and carried at Nazareth Hospital. All patients provided informed consent. Thirteen chronic dialysis patients with HFrHF (FE<40%) were recruited. All patients received conventional dialysis regimens (3 sessions a week for HD; daily dialysis for PD) and all received conventional treatment for CHF and other background illnesses. Patients were treated with Sacubitril/Valsartan at incremental doses 2X50 up to 2X200 mg/day and blood samples were collected and ECHO was performed at baseline and after 3 and 6 months after treatment. Also, quality of life was assessed by Cardiomyopathy Questionnaire (Kansas City KCCQ-12) before and after life after Sacubitril/Valsartan adminsitration.


Administration of Sac/Val to dialysis patients with HFrEF for 6 months gradually improved EF independently of morphological changes in cardiac geometry, as was assessed by echocardiography, and hemodynamic alterations. Specifically, EF was 32.1±1.15% at baseline and increase to 41.15±1.78% (P<0.01) and 48.63±4.72 (P<0.005) following 3 and 6 months of treatment with Sacubitril/Valsartan, respectively. This improvment was associated with significanly reduction in pulmonary artery systolic pressure (PASP). Interestingly, the quality of life significantly improved after Sacubitril/Valsartan treatment. No major adverse effects were reported in the present study, supporting the safety of Sacubitril/Valsartan at least in these patients and for the applied follow up period.


Collectively, these findings support the use of Sac/Val as cardio protective agent in dialysis patients with HFrEF.


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