Abstract: TH-PO0300
Safety and Outcomes of SGLT2 Inhibitors and/or Sacubitril/Valsartan in Patients with CKD KDIGO G5 and Heart Failure
Session Information
- Hypertension and CVD: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Nieves Hernández, Luz Atenas, Tecnologico de Monterrey - Campus Ciudad de Mexico, Mexico City, CDMX, Mexico
- Arvizu Hernández, Mauricio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
- Barron, Clemente, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
Background
Patients with chronic kidney disease (CKD) have an increased cardiovascular risk. iSGLT2 and sacubitril/valsartan are core components of guideline-directed medical therapy for heart failure (HF), with demonstrated cardiovascular benefits. Their use in patients with advanced CKD has been explored in limited observational studies.
Methods
We conducted a retrospective analysis of patients with CKD and HF followed at the cardiorenal clinic of INCMNSZ who were initiated on SGLT2 inhibitors and/or sacubitril/valsartan from jan/2020 to may/2025.
Results
Sixty patients were included; 60% were male, with a mean age of 40.9 years (±14.7). Most patients (88.5%) were on renal replacement therapy, and the rest were predialysis with a mean eGFR of 17.4 mL/min/1.73 m.
CKD etiologies included unknown (39.3%), diabetes (22.9%), lupus (16.3%), and glomerular diseases (14.7%). In terms of therapy, 45% received both agents, 20% received sacubitril/valsartan alone, and 35% received only an iSGLT2. The average treatment duration was 660 days for SGLT2 inhibitors and 768 days for sacubitril/valsartan.
At baseline, HFrEF and HFpEF were equally prevalent (34.6% each). Echocardiographic abnormalities included uremic cardiomyopathy (55.1%), valvular disease (75%), and diastolic dysfunction (48.2%). Follow-up echocardiograms showed improvements in LVEF, valvular pathology, and diastolic function. Laboratory parameters remained stable. During follow-up, 43 hospitalizations and 5 deaths were recorded.
Conclusion
iSGLT2 and sacubitril/valsartan appear safe and well tolerated in patients with CKD G5 and HF, with evidence of cardiovascular improvement. These findings support their use in this high-risk population, though larger studies are needed to validate these results.