Benefits of sacubitril/valsartan in people with heart failure and CKD

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Created On: 02/08/2025

Managing patients with both heart failure (HF) and chronic kidney disease (CKD) presents clinical complexities, often requiring tailored treatment approaches to enhance patient outcomes.

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Key take away

Using sacubitril/valsartan markedly improves renal function and cardiac performance while reducing hospitalizations in heart failure patients with chronic kidney disease.

Background

Managing patients with both heart failure (HF) and chronic kidney disease (CKD) presents clinical complexities, often requiring tailored treatment approaches to enhance patient outcomes. This prospective observational study investigated the impact of sacubitril/valsartan on renal function, cardiac performance, and hospitalization frequency in HF patients suffering from CKD.

Method

This study enrolled 196 HF people with CKD stages 2 to 4. All volunteers received sacubitril/valsartan according to FDA-recommended dosing. The key endpoint was the change in estimated glomerular filtration rate (eGFR), while secondary endpoints encompassed left ventricular ejection fraction (LVEF) and hospitalization rates.

Evaluations of renal function (eGFR), LVEF, hospitalization rates, and adverse events were carried out at 3, 6, and 12 months. Data analysis was performed via SPSS version 25, with statistical significance set at p < 0.05.

Result

Over the 12-month follow-up, the mean eGFR rose from 45.8 ± 12.4 to 48.5 ± 11.5 mL/min/1.73 m² (p = 0.032), reflecting a 5.90% improvement. Hospitalizations dropped markedly from 210 to 48 events, translating to a decline in hospitalization rate from 65.31% to 17.35%. LVEF showed a notable rise from 32.5 ± 6.7% to 41.5 ± 6.1%, representing a 27.69% gain.

Improvement in the New York Heart Association (NYHA) functional class was also observed: the proportion of patients in class II escalated from 43.88% to 63.27%, while those in class IV dropped from 16.33% to 9.18%. Adverse events included hyperkalemia (11.22%), symptomatic hypotension (8.16%), and worsening renal function (5.10%). Treatment discontinuation owing to adverse effects occurred in 7.14% of patients.

Conclusion

Sacubitril/valsartan therapy was linked with remarkable enhancements in cardiac function, reduced hospitalization rates, and preservation of kidney function in HF patients battling CKD. These findings support its beneficial role in managing this high-risk patient group.