A prospective cohort study of the therapeutic effects of sacubitril/valsartan in peritoneal dialysis patients with refractory hypertension
10.3760/cma.j.cn441217-20240920-00935
- VernacularTitle:沙库巴曲缬沙坦对腹膜透析合并难治性高血压患者疗效的前瞻性队列研究
- Author:
Lu YANG
1
;
Na CHEN
1
;
Lu LI
1
;
Lan YANG
1
;
Caiping ZHAO
1
;
Mei XU
1
;
Na TIAN
1
Author Information
1. 宁夏医科大学总医院肾脏内科 宁夏肾脏疾病临床研究中心，银川 750004
- Publication Type:Journal Article
- Keywords:
Peritoneal dialysis;
Hypertension;
Clinical protocol;
Refractory hypertension;
Sacubitril/valsartan
- From:
Chinese Journal of Nephrology
2025;41(11):870-875
- CountryChina
- Language:Chinese
-
Abstract:
In this single-arm prospective cohort study, the aim was to evaluate the antihypertensive efficacy and safety of the angiotensinⅡreceptor-neprilysin inhibitor sacubitril/valsartan in patients with refractory hypertension (RH) undergoing peritoneal dialysis. A total of 67 peritoneal dialysis patients with regular treatment for ≥ 3 months and confirmed RH were enrolled. Sacubitril/valsartan was added to the background antihypertensive therapy and titrated according to a standardized protocol for 6 months. Data on RH control, demographic and clinical characteristics, and adverse reactions were collected before and after intervention. The mean values of valid 24 h ambulatory blood pressure recordings, nocturnal systolic blood pressure (SBP) dipping percentage, blood pressure variability parameters, and the blood pressure control rate were compared before and after treatment. Laboratory and clinical data were also compared. After a median follow-up of 8.0 (4.0, 12.5) months, 50 patients completed the study. After treatment, all blood pressure parameters significantly decreased compared with baseline. The mean values of valid 24 h SBP decreased by 9.52 mmHg ( t=4.79, P<0.001) and the mean values of valid 24 h diastolic blood pressure (DBP) decreased by 7.55 mmHg ( t=5.90, P<0.001). Day-time SBP decreased by 10.82 mmHg ( t=5.22, P<0.001) and day-time DBP by 8.41 mmHg ( t=6.28, P<0.001). Night-time SBP decreased by 6.93 mmHg ( t=2.81, P=0.007) and night-time DBP by 4.95 mmHg ( t=3.12, P=0.003). The standard deviation (SD) of 24 h-SBP ( t=2.43, P=0.018), 24 h DBP-SD ( t=3.82, P<0.001), day-time DBP-SD ( t=2.80, P=0.007), and the coefficient of variation of 24 h-DBP ( t=2.04, P=0.046) were significantly reduced. The blood pressure control rate increased from 14.90% to 44.80% ( χ2=12.89, P<0.001). During follow-up, no patient experienced acute deterioration of renal function. One case of hyperkalemia returned to normal after appropriate treatment, and no serious adverse events occurred. These findings suggest that sacubitril/valsartan effectively lowers blood pressure and improves the blood pressure control rate in peritoneal dialysis patients with RH, with favorable safety and tolerability.
