• Internal medicine · May 2022

    Acute Tubular Necrosis Associated with Angiotensin Receptor-Neprilysin Inhibitor.

    • Moo Jun Kim, Ha Nee Jang, Haa-Na Song, Jong Sil Lee, and Min Gyu Kang.
    • Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Korea.
    • Intern. Med. 2022 May 15; 61 (10): 1573-1576.

    AbstractSacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), significantly reduces mortality and morbidity in patients with chronic heart failure with a reduced ejection fraction (HFrEF). However, a considerable number of patients treated with sacubitril/valsartan experience hypotension, oliguria, progressive azotemia, and renal failure as adverse events. These issues have been linked to significant gaps in the usage and dosing of guideline-directed medical therapy with ARNI in patients with HFrEF. We herein report a relevant case of pathologically proven acute tubular necrosis after the first dose of sacubitril/valsartan, highlighting the importance of optimizing the medical therapy in an outpatient with HFrEF.

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