Switching from ARBs to sacubitril/valsartan in patients with advanced CKD significantly reduced 24-hour systolic blood pressure by 7.1 mmHg from baseline (P < 0.01).
Does switching from ARBs to sacubitril/valsartan improve 24-hour ambulatory blood pressure in patients with advanced non-dialysis CKD?
Switching from ARBs to sacubitril/valsartan significantly reduced 24-hour systolic blood pressure without worsening renal function or causing severe hyperkalemia in patients with advanced CKD.
Mean Difference: -7.1
p-value: p=< 0.01
BACKGROUND: We investigated the effects of sacubitril/valsartan, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), on 24-hour blood pressure (BP) and safety for 12 weeks in Japanese patients with non-dialysis advanced chronic kidney disease (CKD). METHODS: We conducted a prospective, single-arm exploratory study. Patients with non-dialysis CKD stage G4-5 (estimated glomerular filtration (eGFR) 6.0 mmol/L or serum Cr ≥ 30% increase from baseline were reported after sacubitril/valsartan initiation. CONCLUSIONS: Switching from ARB to sacubitril/valsartan can safely enhance 24-hour antihypertensive treatment in patients with non-dialysis CKD G4-5 who do not achieve BP goals with ARBs. CLINICAL TRIALS REGISTRATION: Trial Number jRCT1031220149. CLINICAL TRIALS REGISTRATION: Trial Number jRCT1031220149.
Kinguchi et al. (Mon,) conducted a other in non-dialysis advanced chronic kidney disease (CKD) (n=30). sacubitril/valsartan vs. ARB (baseline) was evaluated on changes from baseline in the 24-hour systolic BP (SBP) measured via ambulatory BP monitoring (ABPM) over 12 weeks (MD -7.1 mmHg, p=< 0.01). Switching from ARBs to sacubitril/valsartan in patients with advanced CKD significantly reduced 24-hour systolic blood pressure by 7.1 mmHg from baseline (P < 0.01).