Renal events in patients receiving neprilysin inhibitors: a systematic review and meta-analysis
Nephrology Dialysis Transplantation, ISSN: 1460-2385, Vol: 37, Issue: 12, Page: 2418-2428
2022
- 8Citations
- 24Captures
- 1Mentions
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Metrics Details
- Citations8
- Citation Indexes8
- CrossRef1
- Captures24
- Readers24
- 24
- Mentions1
- News Mentions1
- 1
Most Recent News
New Chronic Kidney Disease Findings Has Been Reported by Investigators at Hannover Medical School (Renal Events In Patients Receiving Neprilysin Inhibitors: a Systematic Review and Meta-analysis)
2023 NOV 17 (NewsRx) -- By a News Reporter-Staff News Editor at Disease Prevention Daily -- A new study on Kidney Diseases and Conditions -
Article Description
Background: While it is well known that angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARBs) increase the risk of acute renal failure, the role of neprilysin inhibition (NEPi) is unclear and some physicians are reluctant to prescribe sacubitril/valsartan because of safety concerns. This meta-analysis aimed to examine the risk for renal events, progression of chronic kidney disease (CKD) or progression to dialysis on combined NEPi and ACEi/ARBs compared with ACEi or ARBs. Methods: We performed a systematic meta-analysis including 17 randomized controlled trials (study drug sacubitril/valsartan or omapatrilat), involving a total of 23 569 patients, after searching PubMed, Cochrane, ClinicalTrials.org and Embase for eligible studies. From the included trials, all renal endpoints, including long- and short-term outcomes and hyperkalemia, were extracted. Pooled odds ratios (ORs) were calculated using the DerSimonian and Laird method. The study was registered at PROSPERO. Results: Overall, treatment with sacubitril/valsartan or omapatrilat showed a slightly lower risk of any renal event [OR 0.82 (0.7-0.97)] compared with treatment with an ACEi or ARB alone. Also, there was a decreased risk of severe acute renal events [OR 0.8 (0.69-0.93)] and a decrease in estimated glomerular filtration rate decline [mean difference -0.58 mL/min (-0.83 to -0.33 mL/min)]. There was no difference in chronic renal events [OR 0.92 (0.8-1.05)] or hyperkalemia [OR 1.02 (0.84-1.23)]. Conclusion: NEPi + ACEi/ARBs are safe in terms of renal adverse events. Longer trials focusing on CKD are needed to evaluate the effect of NEPi on decreasing progression of CKD.
Bibliographic Details
Oxford University Press (OUP)
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