{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:07:22Z","timestamp":1790676442864,"version":"4.1.0"},"reference-count":69,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":448,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Angiotensin receptor\u2013neprilysin inhibitor (ARNI) has played an increasingly important role in the management of heart failure (HF). However, the evidence on the benefits of ARNI in HF patients with end-stage kidney disease (ESKD) undergoing dialysis is limited. This study aimed to investigate the efficacy and safety of ARNI in patients with concomitant HF and ESKD on maintenance dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We systematically searched the MEDLINE, Embase, Web of Science, Cochrane, and ClinicalTrials.gov databases for studies reporting outcomes after ARNI treatment in HF patients with ESKD on dialysis. All meta-analyses were performed using the random effects model. Twenty-six studies comprising 2494 patients with concomitant HF and ESKD undergoing dialysis were included. Our synthesis showed a significant improvement in left ventricular ejection fraction (LVEF) between before and after ARNI treatment (mean change: 8.05%; 95% confidence interval [CI] 5.57\u201310.54). Compared to the conventional group, the ARNI group showed a greater improvement in LVEF (mean difference: 4.03%; 95% CI 2.90\u20135.16). This effect was more pronounced in patients with HF with reduced ejection fraction (pinteraction\u2009&amp;lt;\u20090.0001). Patients treated with ARNI had a lower risk of all-cause mortality (risk ratio [RR] 0.64; 95% CI 0.45\u20130.92; p\u2009=\u20090.01) but had a similar rate of HF hospitalization (RR 0.71; 95% CI 0.43\u20131.18; p\u2009=\u20090.19). ARNI treatment showed benefits in the improvement of left ventricular end-systolic diameter, left ventricular mass index, left atrial diameter, and E\/e\u2032 ratio (p\u2009&amp;lt;\u20090.05), while it did not significantly increase the risk of severe hyperkalaemia (p\u2009=\u20090.33) or symptomatic hypotension (p\u2009=\u20090.53).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta-analysis provided insights into the benefits of ARNI in HF patients with ESKD undergoing dialysis by improving left ventricular function, reversing left ventricular remodelling, and reducing the risk of all-cause mortality, without increasing the risk of HF hospitalizations, severe hyperkalaemia, and symptomatic hypotension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3454","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T02:48:54Z","timestamp":1725936534000},"page":"72-84","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Efficacy and Safety of Angiotensin Receptor\u2013Neprilysin Inhibition in Heart Failure Patients with End-Stage Kidney Disease on Maintenance Dialysis: A Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7487-219X","authenticated-orcid":false,"given":"Dung Viet","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, VNU University of Medicine and Pharmacy , Hanoi ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh Ngoc","family":"Le","sequence":"additional","affiliation":[{"name":"VNU University of Medicine and Pharmacy , Hanoi ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4973-6919","authenticated-orcid":false,"given":"Binh Quang","family":"Truong","sequence":"additional","affiliation":[{"name":"University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1742-3061","authenticated-orcid":false,"given":"Hoai Thi Thu","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, VNU University of Medicine and Pharmacy , Hanoi ,","place":["Vietnam"]},{"name":"Vietnam National Heart Institute, Bach Mai Hospital , Hanoi 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