Key result
ARNI linked to ~37% lower odds of severe eGFR decline or ESRD versus ACEi/ARB.
Why the study?
Although ARNI reduces major cardiovascular events in HFrEF, its effects on renal outcomes compared with classical RASI remain uncertain.
Does ARNI reduce renal impairment and eGFR decline compared to ACEi/ARB in patients with cardiovascular disease and chronic kidney disease?
Comparison
ARNI vs classical RASI (ACEi/ARB)
Design
Systematic review and meta-analysis
Authors
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ARNI therapy is associated with a lower risk of renal impairment and significant e.
Meta-Analysis
Does ARNI reduce renal impairment and eGFR decline compared to ACEi/ARB in patients with cardiovascular disease and chronic kidney disease?
Odds Ratio: 0.63
ARNI therapy is associated with a lower risk of renal impairment and significant eGFR decline or ESRD compared to ACEi/ARB, supporting its renal safety profile.
Covic et al. (2025) conducted a meta-analysis in Cardiovascular disease, chronic kidney disease, and heart failure with reduced ejection fraction. Angiotensin receptor neprilysin inhibitors (ARNI) vs. Renin-angiotensin system inhibitors (ACEi/ARB) was evaluated on ≥50% reduction in estimated glomerular filtration rate (eGFR) or progression to end-stage renal disease (ESRD), worsening renal function, and renal impairment (37% reduction in odds). Compared with ACEi/ARB, ARNI treatment was associated with a 31% reduction in renal impairment and a 37% reduction in the odds of a ≥50% decline in eGFR or progression to ESRD.
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