WCN26-3636 Relationship between overhydration, inflammation, and skeletal muscle mass in hemodialysis: A longitudinal study using BWA bioimpedance

Introduction:The angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan, a novel therapeutic agent for chronic heart failure and hypertension, has demonstrated significant benefits in reducing cardiovascular events and mortality.However, the clinical usefulness in patients with advanced chronic kidney disease, especially end-stage kidney disease (ESKD) on maintenance dialysis, has not been fully defined so far.We investigated the efficacy and safety of sacubitril/ valsartan in patients on maintenance hemodialysis who had chronic heart failure and/or hypertension at a single affiliated hospital.Methods: Among 140 patients on maintenance hemodialysis in our facility, 64 patients (46%) had heart failure, of which 48 (75%) were treated with ARNI; hypertension without heart failure was observed in other 64 patients, of which 46 (72%) were treated with ARNI.We investigated time-dependent changes in left ventricular (LV) ejection fraction (EF), LV E/e', and LV mass index (LVMI) in these patients for 3 months and some patients for over 1 year.Results: The treatment with sacubitril/valsartan in patients with heart failure significantly improved or tended to improve cardiac function parameters 3 months after administration, with EF by 11%, LV E/e' by -13% (p < 0.01), and LVMI -11% (p < 0.05).Among 4 patients of heart failure with reduced EF (HFrEF) who were able to follow up over 1 year, 3 patients exhibited EF >40%.There were no significant adverse events throughout the observation period in all patients. Conclusion:The patients with ESKD show a significantly high risk of cardiovascular morbidity and mortality, which has been a major healthcare burden.Our findings suggest that the treatment with ARNI in ESKD patients on maintenance hemodialysis may become a preferred option of therapy to ameliorate or prevent heart failure and related complications.Further investigation is needed to confirm the efficacy and to demonstrate a long-term usefulness and safety of ARNI in patients with dialysis-dependent ESKD.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.