eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2023-02-02 11 2 14 15 10.12691/ajmcr-11-2-1 AJMCR20231121 article Noriko Kuwae kwenon@gmail.com 1 Masahiro Yamasato 1 Department of Hemodialysis, Yonabaru Central Hospital, Yonabaru, Okinawa Prefecture, Japan The purpose of this report is to describe effectiveness and tolerability of medical treatment with sacubitril/valsartan in a patient treated with hemodialysis. We describe the case of a 68-year-old man with heart failure with ejection fraction more than 60%, that is HFpEF undergoing hemodialysis. He had several times heart failure due to diastolic dysfunction, he could tolerate a dose of 50/50mg, total 100mg daily. After initiation of sacubitril/valsartan, there was a symptomatic improvement with clear reduction NT-proBNP, left atrial dimension, E/e¡¯ as well as EF. In conclusion, in this patient with diastoric dysfunction undergoing hemodialysis, treatment with sacubitril/valsartan was effective, safe, and improved heart failure symptoms. http://pubs.sciepub.com/ajmcr/11/2/1/ajmcr-11-2-1.pdf Sacubitril/valsartan ARNI heart failure HFpEF hemodialysis