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One-year results of an open-label study on antiproteinuric effect of benidipine in elderly patients with chronic kidney disease.

AbstractBACKGROUND:
The long-term antiproteinuric effects of benidipine, a calcium channel blocker (CCB), have not been evaluated in detail in hypertensive patients with chronic kidney disease (CKD).
METHODS:
Benidipine (4 mg/day) was administered to previously untreated hypertensive patients with CKD, or hypertensive patients with CKD not achieving target blood pressure (BP) despite taking an angiotensin II receptor blocker (ARB). The patients were followed up for 1 year. If target BP was not achieved by 2 weeks after the start of benidipine treatment, the dosage was increased to 8 mg/day. The urinary protein to creatinine (UP/cre) ratio was evaluated before and after benidipine treatment.
RESULTS:
This study evaluated 65 hypertensive patients with CKD. BP (systolic/diastolic) decreased from 154 ± 19 / 91 ± 12 mm Hg before treatment to 134 ± 16 / 78 ± 10 mm Hg at 1 year after treatment (p<0.001). The UP/cre ratio decreased significantly from 2.21 ± 2.47 g/g creatinine (g/g cre) before treatment to 1.43 ± 2.21 g/g cre after treatment (p<0.001). In both the untreated and ARB-treated groups, the BP and UP/cre ratio decreased significantly at 1 year after treatment. The percentage change in the UP/cre ratio was significantly greater in patients aged 65 years or older than in those less than 65 years (79.1% vs. 48.7%, p=0.038).
CONCLUSIONS:
Benidipine treatment reduced the UP/cre ratio in hypertensive patients with CKD, and the percentage decrease of the UP/cre ratio was greater in elderly patients, suggesting that benidipine may have more potent antiproteinuric effects in elderly hypertensive patients with CKD.
AuthorsYasuhiko Tomino, Yoshio Shimizu, Chieko Hamada, Atsushi Kurusu, Isao Ohsawa, Yusuke Suzuki, Toshinao Tsuge, Hiroaki Io, Noriyoshi Kobayashi, Yukihiko Takeda, Katsuhiko Asanuma, Yuichi Tanaka, Hitoshi Suzuki, Jun-Ichiro Nakata, Katsuhiko Takara, Satoshi Horikoshi
JournalJournal of nephrology (J Nephrol) 2011 Nov-Dec Vol. 24 Issue 6 Pg. 756-63 ISSN: 1724-6059 [Electronic] Italy
PMID21360472 (Publication Type: Journal Article)
Chemical References
  • Angiotensin II Type 1 Receptor Blockers
  • Calcium Channel Blockers
  • Dihydropyridines
  • benidipine
  • Creatinine
Topics
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angiotensin II Type 1 Receptor Blockers (pharmacology, therapeutic use)
  • Blood Pressure (drug effects, physiology)
  • Calcium Channel Blockers (pharmacology, therapeutic use)
  • Chronic Disease
  • Comorbidity
  • Creatinine (urine)
  • Dihydropyridines (pharmacology, therapeutic use)
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate (drug effects, physiology)
  • Humans
  • Hypertension (drug therapy, epidemiology, physiopathology)
  • Kidney Diseases (complications, epidemiology, physiopathology)
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proteinuria (etiology, prevention & control, urine)
  • Retrospective Studies
  • Treatment Outcome

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