Safety and efficacy of Sacubitril/Valsartan in control of resistant hypertension in CKD 5D patients

This is a prospective interventional study aimed to study the safety and efficacy of Sacubitril/Valsartan combination therapy in control of resistant hypertension in chronic kidney disease patients on hemodialysis. This study shall include patients aged more than 18 years undergoing hemodialysis and having urine output more than 200 ml/day. The primary and secondary objectives of the study shall be to assess safety and efficacy of Sacubitril/Valsartan respectively in control of resistant hypertension in CKD 5D patients. All patients fulfilling inclusion and exclusion criteria shall be given a run-in period of 2 weeks to exclude ’pseudoresistant’ hypertension by optimising their hemodialysis to achieve their dry body weight and ensuring a sodium restricted diet. Those patients having resistant hypertension post this run-in period shall be given Sacubitril/Valsartan therapy. These patients shall be given thrice a week hemodialysis at dialysis centre in PGIMER Chandigarh. The patients shall be regularly monitored with regards to their serum electrolytes, liver function tests and any adverse effects. The effectiveness of Sacubitril/Valsartan shall be studied with respect to control of office BP, ambulatory BP and if any change in echocardiographic parameters. Sacubitril/Valsartan combination therapy has stood as a potent antihypertensive in previous metanalysis and randomised trials assessing its efficacy in control of resistant hypertension in chronic kidney disease patients. Participation in the study is expected to be beneficial to the patients as control of their hypertension has definite cardiovascular mortality and morbidity benefits.