Abstract
Objective: The main cause of admission in patients with heart failure (HF) is congestion. Treatment is complex, because of resistance to diuretics, and limitation to the use of potassium-sparing drugs. This situation is particularly frequent in patients with heart failure and chronic kidney disease (CKD). Therefore, the use of a drug that acts simultaneously on the renin angiotensin aldosterone system (RAAS) and on the Nerprisilina, can play an important role. Objectives: To evaluate the use of valsartan/sacubitrilo in patients with congestive heart failure and kidney disease 3B-4, analyzing its impact in the improvement of symptoms as overload and the effect on renal function. Analyze the safety profile of the drug Design and method: Prospective observational study (October 2016-October 2017): 7 patients with heart failure, a depressed ejection fraction and dyspnea functional grade II/IV onwards, to which had been added Valsartan/Sacubitrilo, previous suspension of ACE inhibitors or ARA II that came taking Results: The proportion F/M was 5/2. The mean age was 71 years. All patients are hypertensive, (85.6%) diabetic, 71.4% dyslipidemic. The 71 % with Cardiomyopathy. The 57.1% was being treated with combinations of diuretics, reducing this number to the 28.6%, after adding the new drug. 3 of the 7 patients (42.9%) stopped diuretics. There were no significant changes in the glomerular filtration rate, proteinuria and arterial blood pressure. 4 of the 7 patients improved the degree of dyspnea. Only 1 of these patients went to the emergency room with symptoms of heart failure once treated with the drug. None of the patients had adverse effects which would lead to the suspension of the drug. Conclusions: Valsartan/sacubitrilo in patients with CKD is useful to improve the functional class in patients with heart failure, allowing a lower use of diuretics and reducing emergency visits for symptoms in relation to the decompensation of heart failure. It is a reliable drug and help in the therapeutic management of these patients It will be necessary to assess the impact on the long-term preservation of renal function.
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