Why the study?
Sacubitril/valsartan can cause hypotension, oliguria, azotemia, and renal failure, which have been linked to significant gaps in the usage and dosing of guideline-directed medical therapy in HFrEF.
Does sacubitril/valsartan cause acute tubular necrosis in a patient with HFrEF?
Does sacubitril/valsartan cause acute tubular necrosis in a patient with HFrEF?
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Sacubitril/valsartan can be associated with severe acute tubular necrosis even after the first dose, emphasizing the need for careful optimization and monitoring in HFrEF patients.
Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), significantly reduces mortality and morbidity in patients with chronic heart failure with a reduced ejection fraction (HFrEF). However, a considerable number of patients treated with sacubitril/valsartan experience hypotension, oliguria, progressive azotemia, and renal failure as adverse events. These issues have been linked to significant gaps in the usage and dosing of guideline-directed medical therapy with ARNI in patients with HFrEF. We herein report a relevant case of pathologically proven acute tubular necrosis after the first dose of sacubitril/valsartan, highlighting the importance of optimizing the medical therapy in an outpatient with HFrEF.
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Kim et al. (2021) studied this question.
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