Abstract: Ｏｂｊｅｃｔｉｖｅ：To evaluate the safety and effectiveness of sacubitril／valsartan in peritoneal dialysis (PD) patients with severely elevated Nterminal proB type natriuretic peptiede (NTproBNP).
Ｍｅｔｈｏｄｏｌｏｇｙ：From June 2020, 40 patients with maintenance PD>3 months and NTproBNP> 10 000 pg／mL in Ruijin Hospital, Shanghai Jiaotong University School of Medicine, were selected to be treated with sacubitril／valsartan. Baseline, 3months, 6months blood pressure, NTproBNP, cardiac function classification, echocardiogram and other clinical features were collected. According to daily urine output, these patients were further divided into subgroups to compare the clinical parameters before and after treatment.
Ｒｅｓｕｌｔｓ：Until Oct 2021, 39 patients had completed the followup. After 3 and 6 months treatment, the patients serum potassium was still stable within the normal range (3 moths 38±06 mmol／L, 6 moths 40±05 mmol／L), mean systolic blood pressure (1671 mmHg vs 1545 mmHg vs 1534 mmHg,P=0013) and median NTproBNP (33 3109 pg／mL vs 14 049 pg／mL vs 19 735 pg／mL,P=0005) were significantly improved compared to the baselines, the patients with residual urine had a better treatment effect than those with anuria. There was no significant improvement in the various parameters of echocardiography before and after treatment. Ventricular diastolic function in patients with anuria (ventricular septum e′: 803±395 cm／s vs 558±156 cm／s,P=0046; left ventricular side wall e': 1024±419 cm／s vs 706±270 cm／s,P=0028) was even worse than the baselines.
Ｃｏｎｃｌｕｓｉｏｎ：Sacubitril／valsartan not only doesnt affect blood potassium, but also can significantly improve the PD patients blood pressure and heart function, especially in those with residual urine. The role of reversing ventricular remodeling requires a larger sample and longer followup to further explore.

Key words: peritoneal dialysis, heart failur, esacubitril／valsartan, NT-proBNP