{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:56:22Z","timestamp":1785308182948,"version":"3.55.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T00:00:00Z","timestamp":1641859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>While it is well known that angiotensin-converting enzyme inhibitors (ACEi)\/angiotensin receptor blockers (ARBs) increase the risk of acute renal failure, the role of neprilysin inhibition (NEPi) is unclear and some physicians are reluctant to prescribe sacubitril\/valsartan because of safety concerns. This meta-analysis aimed to examine the risk for renal events, progression of chronic kidney disease (CKD) or progression to dialysis on combined NEPi and ACEi\/ARBs compared with ACEi or ARBs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a systematic meta-analysis including 17 randomized controlled trials (study drug sacubitril\/valsartan or omapatrilat), involving a total of 23\u2009569 patients, after searching PubMed, Cochrane, ClinicalTrials.org and Embase for eligible studies. From the included trials, all renal endpoints, including long- and short-term outcomes and hyperkalemia, were extracted. Pooled odds ratios (ORs) were calculated using the DerSimonian and Laird method. The study was registered at PROSPERO.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, treatment with sacubitril\/valsartan or omapatrilat showed a slightly lower risk of any renal event [OR 0.82 (0.7\u20130.97)] compared with treatment with an ACEi or ARB alone. Also, there was a decreased risk of severe acute renal events [OR 0.8 (0.69\u20130.93)] and a decrease in estimated glomerular filtration rate decline [mean difference \u22120.58\u00a0mL\/min (\u22120.83 to \u22120.33\u00a0mL\/min)]. There was no difference in chronic renal events [OR 0.92 (0.8\u20131.05)] or hyperkalemia [OR 1.02 (0.84\u20131.23)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>NEPi\u00a0+\u00a0ACEi\/ARBs are safe in terms of renal adverse events. Longer trials focusing on CKD are needed to evaluate the effect of NEPi on decreasing progression of CKD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfac001","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T04:56:02Z","timestamp":1641617762000},"page":"2418-2428","source":"Crossref","is-referenced-by-count":15,"title":["Renal events in patients receiving neprilysin inhibitors: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9180-0278","authenticated-orcid":false,"given":"Clara","family":"Vollmer Barbosa","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School, Hanover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School, Hanover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette","family":"Melk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School , Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard M W","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School, Hanover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"key":"2022112304493540200_bib1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1042\/CS20150469","article-title":"The natriuretic peptides system in the pathophysiology of heart failure: from molecular basis to treatment","volume":"130","author":"Volpe","year":"2016","journal-title":"Clin Sci (Colch)"},{"key":"2022112304493540200_bib2","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1007\/s40262-017-0543-3","article-title":"Clinical pharmacokinetics of sacubitril\/valsartan (LCZ696): a novel angiotensin receptor-neprilysin inhibitor","volume":"56","author":"Ayalasomayajula","year":"2017","journal-title":"Clin Pharmacokinet"},{"key":"2022112304493540200_bib3","author":"US Food and Drug Administration","journal-title":"Highlights of Prescribing Information"},{"key":"2022112304493540200_bib4","volume-title":"EPAR Summary for the Public","author":"European Medicines Agency"},{"key":"2022112304493540200_bib5","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.amjhyper.2003.09.014","article-title":"omapatrilat and enalapril in patients with hypertension: the omapatrilat cardiovascular treatment vs. enalapril (OCTAVE) trial","volume":"17","author":"Kostis","year":"2004","journal-title":"Am J Hypertens"},{"key":"2022112304493540200_bib6","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/00004872-199207000-00002","article-title":"Candoxatril, a neutral endopeptidase inhibitor: efficacy and tolerability in essential hypertension","volume":"10","author":"Bevan","year":"1992","journal-title":"J Hypertens"},{"key":"2022112304493540200_bib7","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1016\/S0140-6736(05)77712-6","article-title":"Lack of efficacy of neutral endopeptidase inhibitor ecadotril in heart failure. 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