Comparison of the antialbuminuric effects of L-/N-type and L-type calcium channel blockers in hypertensive patients with diabetes and microalbuminuria: the study of assessment for kidney function by urinary microalbumin in randomized (SAKURA) trial.

Abstract

OBJECTIVE:

To clarify whether the L-/N-type calcium channel blocker (CCB) cilnidipine is more renoprotective than the L-type CCB amlodipine in patients with early-stage diabetic nephropathy.

METHODS:

In this prospective, multicenter, open-labeled, randomized trial, the antialbuminuric effects of cilnidipine and amlodipine were examined in renin-angiotensin system (RAS) inhibitor-treated patients with hypertension (blood pressure [BP]: 130-180/80-110 mmHg), type 2 diabetes, and microalbuminuria (urinary albumin to creatinine [Cr] ratio [UACR]: 30-300 mg/g).

RESULTS:

Patients received cilnidipine (n = 179, final dose: 10.27 ± 4.13 mg/day) or amlodipine (n = 186, 4.87 ± 2.08 mg/day) for 12 months. Cilnidipine and amlodipine equally decreased BP. The UACR values for the cilnidipine and amlodipine groups were 111.50 ± 138.97 and 88.29 ± 63.45 mg/g, respectively, before treatment and 107.93 ± 130.23 and 89.07 ± 97.55 mg/g, respectively, after treatment. The groups showed similar changes for the natural logarithm of the UACR, serum Cr, and estimated glomerular filtration rate.

CONCLUSIONS:

Cilnidipine did not offer greater renoprotection than amlodipine in RAS inhibitor-treated hypertensive patients with type 2 diabetes and microalbuminuria.

• Authors: Katsuayuki Ando, Kenji Ueshima, Sachiko Tanaka, Shinji Kosugi, Tosiya Sato, Hiroaki Matsuoka, Kazuwa Nakao, Toshiro Fujita
• Journal: International journal of medical sciences (Int J Med Sci) Vol. 10 Issue 9 Pg. 1209-16 ( 2013) ISSN: 1449-1907 [Electronic] Australia
• PMID: 23935398 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antihypertensive Agents
• Calcium Channel Blockers
• Calcium Channels, L-Type
• Calcium Channels, N-Type
• Dihydropyridines
• Amlodipine
• cilnidipine

Topics

• Aged
• Albuminuria
• Amlodipine (therapeutic use)
• Antihypertensive Agents (therapeutic use)
• Blood Pressure (drug effects)
• Calcium Channel Blockers (therapeutic use)
• Calcium Channels, L-Type (metabolism)
• Calcium Channels, N-Type (metabolism)
• Diabetes Mellitus, Type 2 (drug therapy)
• Diabetic Nephropathies (drug therapy)
• Dihydropyridines (therapeutic use)
• Female
• Humans
• Hypertension (drug therapy)
• Male
• Middle Aged
• Prospective Studies
• Renin-Angiotensin System (drug effects)