The efficacy of sacubitril/valsartan in patients receiving peritoneal dialysis with diabetes and heart failure with preserved ejection fraction.

IF 1.1 4区 医学 Q3 UROLOGY & NEPHROLOGY
Xueyan Bian, Jianwei Ma, Qin Su, Qiang Yu, Jiancheng Huang, Sizeng Bao, Ji Ying
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Abstract

Objective: To investigate the efficacy of sacubitril/valsartan in the treatment of peritoneal dialysis (PD) in patients with diabetes and heart failure with preserved ejection fraction (HFpEF).

Materials and methods: Patients with diabetes who underwent PD and had HFpEF (n = 64) were divided into two groups: the experimental group (n = 31), which was administered sacubitril/valsartan, and the control group (n = 33), administered valsartan alone. Data were collected before and after treatment to compare the inter-group changes in cardiac function indexes, residual renal function (RRF), and PD adequacy indexes.

Results: Compared with the control group, the N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were lower in the experimental group after treatment (Wilcoxon test, p < 0.05). The descent ranges of NT-proBNP, left ventricular end-systolic dimension, and left ventricular fraction shortening, as well as increases in the amplitude of left ventricular ejection fraction after treatment were better in the experimental group than in the control group (t-test, p < 0.05). The descent ranges of residual renal glomerular filtration rate, residual renal Kt/Vurea, and residual renal creatinine clearance, as well as increases in the amplitude of β2-microglobulin, were lower in the experimental group than in the control group (Wilcoxon test, p < 0.05). However, there were no significant differences between the two groups in the descent ranges of the PD adequacy indexes (Wilcoxon test, p > 0.05). Hyperkalemia occurred in 8 cases (25.81%) in the experimental group and 13 cases (39.39%) in the control group, while hypotension occurred in 2 cases (6.45%) and 1 case (3.03%), respectively. No other adverse effects were observed in either group.

Conclusion: The findings suggest that sacubitril/valsartan can safely and effectively improve RRF and cardiac function in patients with diabetes combined with HFpEF receiving PD, but it has little effect on PD adequacy.

沙库比特利/缬沙坦对接受腹膜透析的糖尿病合并射血分数保留型心力衰竭患者的疗效。
目的研究沙库比特利/缬沙坦治疗糖尿病合并射血分数保留型心力衰竭(HFpEF)患者腹膜透析(PD)的疗效:将接受腹膜透析且患有射血分数保留型心力衰竭的糖尿病患者(n = 64)分为两组:实验组(n = 31)和对照组(n = 33),前者服用沙库比特利/缬沙坦,后者仅服用缬沙坦。收集治疗前后的数据,比较组间心功能指标、残余肾功能(RRF)和PD充足性指标的变化:结果:与对照组相比,实验组治疗后的 N 端前 B 型钠尿肽(NT-proBNP)水平更低(Wilcoxon 检验,P < 0.05)。实验组治疗后的 NT-proBNP、左室收缩末期容积和左室缩短率的下降幅度以及左室射血分数振幅的增加均优于对照组(t 检验,P < 0.05)。实验组残余肾小球滤过率、残余肾Kt/Vurea和残余肾肌酐清除率的下降范围以及β2-微球蛋白振幅的增加均低于对照组(Wilcoxon检验,P<0.05)。然而,两组在腹膜透析充分性指数的下降范围上没有明显差异(Wilcoxon 检验,P > 0.05)。实验组和对照组分别有 8 例(25.81%)和 13 例(39.39%)出现高钾血症,分别有 2 例(6.45%)和 1 例(3.03%)出现低血压。两组均未观察到其他不良反应:结论:研究结果表明,沙库比特利/缬沙坦能安全有效地改善接受PD治疗的糖尿病合并HFpEF患者的RRF和心功能,但对PD的充分性影响甚微。
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来源期刊
Clinical nephrology
Clinical nephrology 医学-泌尿学与肾脏学
CiteScore
2.10
自引率
9.10%
发文量
138
审稿时长
4-8 weeks
期刊介绍: Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.
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