Key result
Sacubitril/valsartan is linked to a ~6% eGFR increase over 12 months in HF with CKD.
Why the study?
Patients with heart failure and chronic kidney disease face therapeutic challenges, requiring optimized treatment strategies to improve clinical outcomes and preserve renal function.
Does sacubitril/valsartan improve renal function and clinical outcomes in heart failure patients with chronic kidney disease stages 2-4?
Observational (n=196)
No
Does sacubitril/valsartan improve renal function and clinical outcomes in heart failure patients with chronic kidney disease stages 2-4?
Effect estimate: 5.90% increase
Absolute Event Rate: 48.5% vs 45.8%
p-value: p=0.032
In a prospective observational study, sacubitril/valsartan significantly improved renal function, LVEF, and reduced hospitalizations over 12 months in heart failure patients with CKD stages 2-4.
May preserve renal function while cutting hospitalizations in HF-CKD; leaves open need for RCTs before changing practice.
BACKGROUND: Patients with heart failure (HF) and chronic kidney disease (CKD) often face therapeutic challenges, necessitating optimized treatment strategies to improve clinical outcomes. This study aims to evaluate the effectiveness of sacubitril/valsartan (Entresto) in improving clinical outcomes, reducing hospitalizations, and preserving renal function in HF patients with CKD, with a primary focus on changes in renal function (estimated glomerular filtration rate (eGFR)), and secondary outcomes, including heart performance (left ventricular ejection fraction (LVEF)) and hospitalization rates. METHODOLOGY: This prospective observational study was conducted from January 2023 to December 2023. A total of 196 consecutively enrolled HF patients with CKD stages 2-4 were included and administered sacubitril/valsartan at FDA-recommended doses. Assessments of eGFR, hospitalization rates, LVEF, and adverse events were performed at three, six, and 12 months. Statistical analysis was conducted using SPSS version 25 (IBM Corp., Armonk, NY), and a p-value < 0.05 was considered significant. RESULTS: The mean eGFR improved significantly from 45.8 ± 12.4 mL/min/1.73 m² to 48.5 ± 11.5 mL/min/1.73 m² after 12 months (p = 0.032), representing a 5.90% increase. Hospitalizations decreased markedly from 210 to 48 events, with hospitalization rates dropping from 65.31% to 17.35%. LVEF improved significantly from 32.5 ± 6.7% to 41.5 ± 6.1% (27.69% increase). The New York Heart Association (NYHA) functional class also improved: class II patients increased from 43.88% to 63.27%, while class IV patients declined from 16.33% to 9.18%. Adverse events included hyperkalemia in 11.22%, symptomatic hypotension in 8.16%, and worsening renal function in 5.10% of patients; 7.14% of patients discontinued therapy due to side effects. CONCLUSION: Sacubitril/valsartan demonstrated significant improvement in cardiac function, reduction in hospitalization rates, and preservation of renal function in HF patients with CKD, supporting its clinical utility in this population.
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Zahid et al. (2025) conducted an observational in Heart failure with reduced ejection fraction and chronic kidney disease (n=196). Sacubitril/valsartan vs. Baseline was evaluated on Change in estimated glomerular filtration rate (eGFR) at 12 months (5.90% increase, p=0.032). Sacubitril/valsartan significantly improved mean estimated glomerular filtration rate by 5.90% (from 45.8 to 48.5 mL/min/1.73 m²) over 12 months in heart failure patients with chronic kidney disease.
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