{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:50:20Z","timestamp":1790700620476,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Chronic kidney disease (CKD) is highly prevalent in patients with chronic heart failure (CHF) and increases the risk of overall and cardiovascular (CV) mortality. Despite evidence supporting the effectiveness of angiotensin-converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers, and mineralocorticoid receptor antagonists in decreasing mortality in patients with CHF, CKD hampers the optimization of standard pharmacologic therapy for heart failure. Therefore, other treatment options are needed to optimize treatment outcomes in CHF patients with CKD. The first-in-class angiotensin receptor-neprilysin inhibitor, sacubitril\/valsartan, has a complementary activity that counteracts the potential unwanted long-term effects of over-activation of the renin\u2013angiotensin\u2013aldosterone system. Sacubitril\/valsartan reduced the risk of CV mortality compared to standard therapy with an ACE-I in patients with heart failure with reduced ejection fraction (HFrEF) in the PARADIGM-HF trial and has been shown to be safe and effective in a broad range of HFrEF patients. However, data on the efficacy and tolerability of sacubitril\/valsartan in patients with more advanced CKD are limited. This review discusses the evidence for the role of sacubitril\/valsartan in providing additional renal benefit in patients with HFrEF. Data from clinical trials and real-world experience in patients with HFrEF and advanced CKD support the benefits of dual angiotensin\/neprilysin inhibition across the breadth of kidney disease stages, including patients with significant renal impairment that was not reported in the pivotal PARADIGM-HF trial, and suggests a central role for the cardiac benefits of sacubitril\/valsartan in nephroprotection.<\/jats:p>","DOI":"10.1093\/ehjcvp\/pvab030","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T11:10:59Z","timestamp":1617361859000},"page":"445-452","source":"Crossref","is-referenced-by-count":65,"title":["Renal protection in chronic heart failure: focus on sacubitril\/valsartan"],"prefix":"10.1093","volume":"7","author":[{"given":"Roberto","family":"Pontremoli","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Viale Benedetto 15, 6, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8039-8781","authenticated-orcid":false,"given":"Claudio","family":"Borghi","sequence":"additional","affiliation":[{"name":"Medical and Surgical Sciences Department, University of Bologna, Via Giuseppe Massarenti, 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Perrone Filardi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples, Via Pansini, 5, 80131 Naples, Italy"},{"name":"Mediterranea Cardiocentro, Via Orazio, 2, 80122 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,3]]},"reference":[{"key":"2021092108265418900_pvab030-B1","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1161\/01.CIR.0000116764.53225.A9","article-title":"Renal insufficiency and heart failure: 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