Why the study?
ARNI raises hANP levels, complicating differentiation from fluid overload when setting dry weight in maintenance hemodialysis patients.
Does Angiotensin receptor-neprilysin inhibitor (ARNI) therapy alter hANP and NT-proBNP levels in maintenance hemodialysis patients with stage B heart failure?
Does Angiotensin receptor-neprilysin inhibitor (ARNI) therapy alter hANP and NT-proBNP levels in maintenance hemodialysis patients with stage B heart failure?
In hemodialysis patients with stage B heart failure, ARNI initiation causes an approximately 2-fold pharmacological increase in hANP without worsening clinical parameters, which should not be mistaken for fluid overload.
Clinicians should not mistake ARNI-related hANP rise for fluid overload in HD patients with stage B HF; hypothesis-generating for dedicated outcome trials.
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Fujiwara et al. (2026) studied this question.
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