ArticleClinical and experimental nephrology2024
Sacubitril/valsartan reduces proteinuria depending on blood pressure in patients with stage 4-5 chronic kidney disease.
Article in Clinical and experimental nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Association of angiotensin receptor-neprilysin inhibitor therapy with changes in eGFR slope and home blood pressure in patients with chronic kidney disease.Clinical and experimental nephrology · 2026Article
- Effect of Renin-Angiotensin System Inhibition on Residual Kidney Function in Peritoneal Dialysis.Medicina (Kaunas, Lithuania) · 2026Article
- Surrogate Endpoints in Pivotal Clinical Trials for Drug Approval in Japan Compared to the United States.Clinical and translational science · 2025Article
- Comparison of renal effects between sacubitril/valsartan and thiazide diuretics among patients with uncontrolled hypertension and chronic kidney disease in Japan.Clinical and experimental nephrology · 2025Article
- Effects of Sacubitril/Valsartan on Blood Pressure and Proteinuria in Hypertensive Patients With Chronic Kidney Disease.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Harnessing ARNI in advanced CKD - a new frontier for cardiac and renal protection.International urology and nephrology · 2025Article
- Angiotensin Receptor Neprilysin Inhibitors for Hypertension and Proteinuria Management During Atezolizumab/Bevacizumab Treatment for Hepatocellular Carcinoma.Cancer diagnosis & prognosisArticle
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4 authors.
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Abstract
backgroundBlood pressure (BP) control is an important factor in the management of chronic kidney disease (CKD). Several studies have shown that BP in many patients with CKD remained uncontrolled even with multiple medications. Sacubitril/valsartan, an angiotensin receptor neprilysin inhibitor (ARNI), has been newly approved for treating hypertension in Japan. However, the renoprotective effects remain unclear, particularly in patients with advanced CKD. Here, we investigated the effects on proteinuria of this ARNI in patients with stage 4-5 CKD.
methodsWe retrospectively collected data from outpatients with stage 4-5 CKD who started ARNI from January until December 2023. The primary outcome was the change in urine protein creatinine ratio (UPCR) at 6 months after ARNI initiation. Secondary outcomes were systolic and diastolic BP, estimated glomerular filtration rate (eGFR), serum potassium, and serum uric acid (UA). We analyzed factors associated with 50% UPCR reduction by multivariate analysis.
resultsIn total, 47 patients were analyzed. ARNI reduced UPCR from 2.14 g/gCr (interquartile range; 1.09-2.91) to 1.05 g/gCr (0.42-1.95; p < 0.001). Systolic BP fell from 150.0 mmHg (139.5-160.0) to 134.0 mmHg (124.5-140.0; p < 0.001). No significant changes in eGFR, serum potassium, and serum uric acid were observed, except for a slight decrease in eGFR among patients with conversion from a renin-angiotensin system inhibitor to ARNI. In multivariate regression analysis, higher systolic BP (per 10-mmHg increase) was significantly associated with reduced proteinuria (odds ratio 2.51, 95% confidence interval 1.35-4.66; p = 0.004).
conclusionsARNI reduced proteinuria in patients with stage 4-5 CKD, particularly for those with uncontrolled hypertension.
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