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ホシノ ジュンイチ
Hoshino Junichi
星野 純一 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Successful kidney transplantation after significant improvement of left ventricular function with guideline-directed medical therapy including angiotensin receptor-neprilysin inhibitor and beta blocker in a hemodialysis patient: a case report |
| 掲載誌名 | 正式名：Renal Replacement Therapy ISSNコード：20591381 |
| 掲載区分 | 国外 |
| 出版社 | BioMed Central |
| 巻・号・頁 | 11,pp.s41100-025-00670-3 |
| 著者・共著者 | Ushio Yusuke, Ito Kyoko, Seki Momoko, Nakai Anna, Sumori Hitoko, Kobayashi Shizuka, Makabe Shiho, Manabe Shun, Kataoka Hiroshi, Nitta Kosaku, Hoshino Junichi |
| 担当区分 | 最終著者 |
| 発行年月 | 2025/10/07 |
| 概要 | Background
Although angiotensin receptor-neprilysin inhibitor (ARNI; sacubitril/valsartan) is a well-established treatment for heart failure with reduced ejection fraction (HFrEF), evidence of its efficacy in hemodialysis (HD) patients remains limited. Case presentation We present the case of a 60-year-old woman who underwent HD for 8 years for diabetic nephropathy; 1.5 years prior to heart failure treatment, her echocardiogram revealed a severely reduced left ventricular ejection fraction (LVEF) and left ventricular end-diastolic and end-systolic volume indices (LVEDVI and LVESVI, respectively) of 24%, 91.1, and 69.2, respectively. The patient was considered ineligible for kidney transplantation because of severe left ventricular dysfunction. After referral to our department, heart failure therapy with ARNI and carvedilol were initiated and titrated to sacubitril/valsartan 100 mg/day and carvedilol 20 mg/day. LVEF gradually improved, reaching 56% after 9 months, with improvements in LVESVI (53.5) and LVEDVI (23.5), ultimately leading to successful kidney transplantation. Conclusions This case highlights a rare and successful reversal of severe HFrEF in a HD patient through the safe and effective use of ARNI, enabling eligibility for kidney transplantation. This emphasizes the importance of guideline-directed medical therapy for HD patients with heart failure. |
| DOI | https://doi.org/10.1186/s41100-025-00670-3 |
| 文献番号 | ZB07390002<Pre 医中誌> |