Switching to an L/N-type calcium channel blocker shows renoprotective effects in patients with chronic kidney disease: the Kyoto Cilnidipine Study.

Abstract

OBJECTIVE:

This open-label, randomized controlled trial investigated the effects of cilnidipine, an L/N-type calcium channel blocker (CCB), in patients with chronic kidney disease (CKD).

METHODS:

Sixty patients with CKD and well-controlled hypertension being treated with a renin- angiotensin system (RAS) inhibitor and an L-type CCB (L-CCB) were randomly assigned either to switch from the L-CCB to cilnidipine after a 4-week observation period or to continue with L-CCB treatment. Blood pressure, heart rate and renal function were monitored for 12 months. Data were available for analysis from 50 patients: 24 from the cilnidipine group and 26 from the L-CCB group.

RESULTS:

Blood pressure was well controlled in both groups. After 12 months, proteinuria and heart rate were significantly decreased in the cilnidipine group, but proteinuria increased and heart rate remained unchanged in the L-CCB group. There was a significant positive correlation between the percentage changes in proteinuria and heart rate.

CONCLUSIONS:

Cilnidipine has antihypertensive effects equivalent to those of L-CCBs. In patients with CKD, proteinuria can be decreased by switching from an L-CCB to cilnidipine, thereby improving renal function.

• Authors: T Hatta, K Takeda, Y Shiotsu, C Sugishita, T Adachi, T Kimura, K Sonomura, T Kusaba, N Kishimioto, H Narumiya, S Tanda, K Tamagaki, K Yamada, H Kameyama, H Kido, S Harada, Y Bito, J Moriguchi, S Morimoto, M Okigaki, H Itoh, Y Mori, T Nakata, K Maki, S Sasaki, K Sawada, H Matsubara
• Journal: The Journal of international medical research (J Int Med Res) Vol. 40 Issue 4 Pg. 1417-28 ( 2012) ISSN: 1473-2300 [Electronic] England
• PMID: 22971493 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Adrenergic alpha-1 Receptor Antagonists
• Antihypertensive Agents
• Calcium Channel Blockers
• Calcium Channels, L-Type
• Calcium Channels, N-Type
• Dihydropyridines
• Diuretics
• cilnidipine
• Creatinine

Topics

• Adrenergic alpha-1 Receptor Antagonists (therapeutic use)
• Aged
• Antihypertensive Agents (therapeutic use)
• Calcium Channel Blockers (administration & dosage, adverse effects)
• Calcium Channels, L-Type (physiology)
• Calcium Channels, N-Type (physiology)
• Creatinine (blood)
• Dihydropyridines (administration & dosage, adverse effects)
• Diuretics (therapeutic use)
• Drug Substitution
• Female
• Heart Rate (drug effects)
• Humans
• Hypertension (drug therapy)
• Kidney (drug effects, physiopathology)
• Male
• Middle Aged
• Proteinuria (blood, drug therapy, urine)
• Regression Analysis
• Renal Insufficiency, Chronic (blood, drug therapy, urine)