Sacubactril valsartan in hypertension without heart failure in chronic kidney disease patients
Objective:To observe the efficacy of sacubactril valsartan and the change of inflammatory factors in chronic kidney disease(CKD)complicated with hypertension and non-heart failure.Methodology:CKD patients with hypertension and non-heart failure in our hospital from January 2021 to June 2023 were collected.The control group was treated with Valsartan,and the treatment group was treated with sacubactril valsartan.The cardiac indicators,renal indicators and inflammatory cytokines,early deterioration of renal function(eGFR decreased by more than 20%from baseline)were followed up after 6 months.Results:A total of 60 CKD(the percentage of CKD 3～4 stage is 76.7%)patients were included.(1)There was no significant difference of the clinical data,cardiac and renal parameters between the treatment group(n=30)and the control group(n=30)before treatment(P＞0.05).(2)Comparedwithbaseline,the blood pressure of both groups decreased,and the decline was even greater in treatment group(P＜0.05).Compared with baseline,24-hour urinary protein,serum creatinine and N-terminal pro-B-type natriuretic peptide(NT-proBNP)decreased;estimated glomeruar filtration rate(eGFR),left ventricular ejection fraction(LVEF)and serum albumin increased in the treatment group(P＜0.05),While serum creatinine increased and eGFR decreased after 6 months of Valsartan treatment(P＜0.05).The change percentage of serum creatinine,eGFR,NT-proBNP and LVEF between two groups have statistical significance(P＜0.05).(3)In the treatment group,IL-1β,IL-2R,IL-6and IL-8decreased(P＜0.05),while IL-10 and TNF-α had no change(P＞0.05).The above inflammatory factors had no significant difference after treatment in the control group.(4)The renal function deterioration incidence of renal function of treatment group was significantly lower than that control group(3.3%vs 33.3%,P＜0.05).Sacubactril valsartan treatment(OR=0.013 95%CI 0.000,0.562)and the baseline 24-hour urinary protein quantity(OR=2.268,95%CI 1.313,3.919)were independent influencing factors for renal function deterioration events.(5)There was no significant difference in the incidence of hyperkalemia between two groups(10%vs 6.7%,P＞0.05).No obvious adverse reactions such as hypotension,cough and angioneurotic edema occured in both groups.Conclusion:Sacubactril valsartan can effectively induce blood pressure,proteinuria and inflammation,improve the cardiac function,renal function and renal prognosis in CKD 1～4 stage with hypertension and non-heart failure patients.
NETL
NSTL
万方数据
