{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:41:48Z","timestamp":1792813308625,"version":"4.5.0"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,4,18]]},"abstract":"<jats:p xml:lang=\"en\">The incidence of heart failure and chronic kidney disease is increasing, and many patients develop both diseases. Angiotensin receptor\u2010neprilysin inhibitor (ARNI) is a promising therapeutic candidate for both diseases. ARNI has demonstrated superior cardioprotective effects compared with renin\u2013angiotensin system inhibitors (RAS\u2010Is) in large clinical trials such as the PARADIGM\u2010HF (Prospective Comparison of ARNI With ACEI [Angiotensin\u2010Converting Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial. It has also been suggested that ARNI can provide renoprotective effects beyond those of RAS\u2010Is in patients with HF. ARNI might have beneficial effects on the kidneys because of its ability to improve cardiac function in patients with heart failure and affect renal hemodynamics by enhancing the effects of hormones such as natriuretic peptide. In contrast, in the PARADIGM\u2010HF trial, ARNI was associated with more albuminuria compared with RAS\u2010I; thus, it is unclear whether long\u2010term ARNI therapy has renoprotective effects. Additionally, ARNI did not provide renoprotective effects beyond RAS\u2010I in patients with chronic kidney disease in the UK HARP\u2010III (United Kingdom Heart and Renal Protection\u2010III) trial. In other words, the patient population in which ARNI is more renoprotective than RAS\u2010I might be limited. Collectively, ARNI may have renoprotective effects in addition to cardioprotective effects, but the evidence to date is applicable only to heart failure. Theoretically, given the molecular mechanism of ARNI, it could also be renoprotective in conditions such as nephrosclerosis, which has low risks of albuminuria and reduced kidney perfusion, but the evidence for such effects is lacking. Further research is needed to clarify whether ARNI therapy is an acceptable treatment strategy for renal protection.<\/jats:p>","DOI":"10.1161\/jaha.122.029565","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T09:13:32Z","timestamp":1681722812000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Updates for Cardio\u2010Kidney Protective Effects by Angiotensin Receptor\u2010Neprilysin Inhibitor: Requirement for Additional Evidence of Kidney Protection"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1146-6810","authenticated-orcid":false,"given":"Shunichiro","family":"Tsukamoto","sequence":"first","affiliation":[{"name":"Department of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Yokohama 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