Acute Tubular Necrosis Associated with Angiotensin Receptor-neprilysin Inhibitor.

Abstract

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.

• Authors: Moo Jun Kim, Ha Nee Jang, Haa-Na Song, Jong Sil Lee, Min Gyu Kang
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 61 Issue 10 Pg. 1573-1576 (May 15 2022) ISSN: 1349-7235 [Electronic] Japan
• PMID: 34707049 (Publication Type: Journal Article)

Chemical References

• Aminobutyrates
• Angiotensin Receptor Antagonists
• Antihypertensive Agents
• Biphenyl Compounds
• Drug Combinations
• Receptors, Angiotensin
• Tetrazoles
• sacubitril
• Valsartan
• Neprilysin

Topics

• Aminobutyrates
• Angiotensin Receptor Antagonists (adverse effects)
• Antihypertensive Agents (therapeutic use)
• Biphenyl Compounds (pharmacology, therapeutic use)
• Drug Combinations
• Heart Failure
• Humans
• Necrosis (chemically induced)
• Neprilysin (pharmacology, therapeutic use)
• Receptors, Angiotensin (therapeutic use)
• Stroke Volume
• Tetrazoles (adverse effects)
• Treatment Outcome
• Valsartan (adverse effects)