Chronic kidney disease has an increased health impact on a global scale, with the most common etiologies being hypertension and diabetes. It is most frequently linked to noncommunicable conditions, including diabetes and hypertension, among high-income nations. However, it has a couple of new potential etiologies in low- and middle-income countries, many of which are yet unknown, including viral infections and environmental toxins. The phrase "CKD of unknown etiology" (CKDu) has been used to refer to CKD that is not caused by a typical risk factor such as diabetes, high blood pressure, or HIV. Environmental variables have been investigated as potential contributors to CKDu, including heavy metal exposure, elevated seasonal temperatures, pesticide use, mycotoxins, contamination of water supplies, and snake bites. Furthermore, the underlying causes have not been definitively established in the majority of areas and identifying serious health consequences across different international contexts and populations may be crucial for comprehending and avoiding CKDu.

This review article discusses the Angiotensin Receptor-Neprilysin Inhibitor which is remedy made up of two anti-hypertensive pharmaceuticals (sacubitril and valsartan). These medications may prolong life expectancy more than ACE inhibitors, which have been routinely used to treat heart failure. ARNi is now being used to treat individuals with heart failure those who have a low ejection fraction, which means their basic pumping chamber isn't working properly. Patients must be symptomatic despite receiving effective medical treatment for heart failure or be unable to tolerate a sufficient dose of ACE inhibitors to be eligible. Sacubitril and/or Valsartan are the debut members of a latest class of drugs described as angiotensin receptor neprilysin inhibitors to receive FDA approval (ARNI). The FDA has approved the medicine for the management of chronic heart failure sufferers with a lower ejection fraction and NYHA classifications II, III, or IV. Before commencing sacubitril and/or valsartan, patients must have to be able to accommodate ACEI or ARB. This intervention covers the instances, mode of action, approaches of administration, significant toxic reactions, risks and benefits, bioactivity, and surveilling of sacubitril & valsartan so as to the practitioners can control patients under therapy in settings into which it implies as a part of the effective interprofessional.