{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:34:58Z","timestamp":1792420498892,"version":"4.5.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>We investigated the effects of sacubitril\/valsartan, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), on 24-hour blood pressure (BP) and safety for 12 weeks in Japanese patients with non-dialysis advanced chronic kidney disease (CKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a prospective, single-arm exploratory study. Patients with non-dialysis CKD stage G4-5 (estimated glomerular filtration (eGFR) &amp;lt;30 mL\/min\/1.73 m2) who did not achieve their BP goals with angiotensin receptor blocker (ARB) administration, were enrolled and switched to sacubitril\/valsartan. Primary and key secondary endpoints were changes from baseline in the 24-hour systolic BP (SBP) measured via ambulatory BP monitoring (ABPM) over 12 weeks and the safety, especially incidence of serum creatinine (Cr) increase (\u2265\u200530% increase from baseline) and hyperkalemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Thirty patients were enrolled, and 29 patients were switched to sacubitril\/valsartan. Efficacy analysis was conducted on 26 patients. Baseline mean eGFR and office BP were 21.1\u2005\u00b1\u20055.0 mL\/min\/1.73m2 and 149.4\u2005\u00b1\u200523.7\/80.7\u2005\u00b1\u200511.9 mmHg, respectively. Baseline 24-hour, daytime, and nighttime BP were 139.6\u2005\u00b1\u200517.7\/77.0\u2005\u00b1\u20057.8 mmHg, 143.5\u2005\u00b1\u200518.5\/79.6\u2005\u00b1\u20058.7 mmHg, and 131.0\u2005\u00b1\u200520.4\/71.1\u2005\u00b1\u20058.8 mmHg, respectively. After 12 weeks, changes in 24-hour, daytime, and nighttime SBP from baseline were -7.1\u2005\u00b1\u200512.4 mmHg (P\u2005&amp;lt;\u20050.01), -7.7\u2005\u00b1\u200512.9 mmHg (P\u2005&amp;lt;\u20050.01), and -5.8\u2005\u00b1\u200515.8 mmHg (P\u2005=\u20050.07), respectively. No incidences of potassium values\u2005&amp;gt;\u20056.0 mmol\/L or serum Cr\u2005\u2265\u200530% increase from baseline were reported after sacubitril\/valsartan initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Switching from ARB to sacubitril\/valsartan can safely enhance 24-hour antihypertensive treatment in patients with non-dialysis CKD G4-5 who do not achieve BP goals with ARBs. CLINICAL TRIALS REGISTRATION: Trial Number jRCT1031220149.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL TRIALS REGISTRATION<\/jats:title>\n                    <jats:p>Trial Number jRCT1031220149.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaf028","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T07:17:43Z","timestamp":1741159063000},"page":"380-388","source":"Crossref","is-referenced-by-count":5,"title":["Switching From ARBs to Sacubitril\/Valsartan Safely Improves 24-Hour Ambulatory Blood Pressure in Patients With Advanced Chronic Kidney Disease"],"prefix":"10.1093","volume":"38","author":[{"given":"Sho","family":"Kinguchi","sequence":"first","affiliation":[{"name":"Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine , Yokohama ,","place":["Japan"]},{"name":"Department of Nephrology and Hypertension, 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,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Kanaoka","sequence":"additional","affiliation":[{"name":"Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine , Yokohama ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"YCU Co-Creation Innovation Center, Yokohama City University , Yokohama ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Haze","sequence":"additional","affiliation":[{"name":"YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital , Yokohama ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhito","family":"Hirawa","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Yokohama City 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