Angiotensin receptor-neprilysin inhibitor in patients with heart failure and chronic kidney disease

In Jeong Cho, Seok Min Kang

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)


Despite significant advances in the management of heart failure with reduced ejection fraction (HFrEF), there remains an enormous health problem with high morbidity and mortality over the last few decades. The neprilysin inhibitor enhances the activity of natriuretic peptides, producing vasodilation, natriuresis, and diuresis. Angiotensin receptor blockers inhibit the renin-angiotensin-aldosterone system. Sacubitril/valsartan, a first-in-class angiotensin receptor-neprilysin inhibitor (ARNI), has been shown to improve cardiovascular outcomes in HFrEF and delay the progression of chronic kidney disease (CKD) in patients with HFrEF. The PARADIGM-HF study showed a reduction in diuretic need in the ARNI group. While the use of diuretics is effective in volume control in patients with HFrEF, their use has the potential to adversely affect renal function. Therefore, ARNI therapy could benefit patients with heart failure and CKD by reducing cardiovascular morbidity and mortality and possibly retarding the progression of CKD, although more clinical evidence is required in patients with severe CKD and end-stage renal disease.

Original languageEnglish
Pages (from-to)555-565
Number of pages11
JournalKidney Research and Clinical Practice
Issue number4
Publication statusPublished - 2021 Dec

Bibliographical note

Publisher Copyright:
© 2021 by The Korean Society of Nephrology.

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology


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