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Acute Tubular Necrosis Associated with Angiotensin Receptor-neprilysin Inhibitor
Authors:Moo Jun Kim  Ha Nee Jang  Haa-Na Song  Jong Sil Lee  Min Gyu Kang
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.
Keywords:angiotensin receptor-neprilysin inhibitor   heart failure with reduced ejection fraction   acute tubular necrosis   HFrEF
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