Document Detail

Acute renal effects of felodipine in hypertensive patients with kidney disease.
MedLine Citation:
PMID:  1614059     Owner:  NLM     Status:  MEDLINE    
In contrast to other types of directly acting vasodilators, calcium antagonists promote sodium excretion. It is not well established, however, whether these drugs also induce natriuresis in hypertensive patients with renal disease. Therefore, we studied the acute effects of the dihydropyridine calcium antagonist felodipine in nine such patients (CCr 68 +/- 19 ml/min) and 12 healthy normotensive subjects. In both the hypertensive patients and the normotensive subjects total and fractional sodium excretion rose during the first 40 minutes of intravenous felodipine infusion; in the hypertensive patients this rise of sodium excretion was positively correlated to the initial glomerular filtration rate (GFR) (r = 0.87, P less than 0.01). In the patients, during ongoing felodipine infusion, natriuresis was attenuated in the setting of a large continuing decrease of blood pressure. In contrast, in the normotensive subjects, in whom blood pressure did not fall any further, a steady rise of sodium excretion was observed. In both the hypertensive patients and the normotensive subjects GFR remained unchanged and renal vascular resistance decreased, whereas renal plasma flow increased only in the latter group. Changes in sodium excretion were not correlated to changes in renal hemodynamic parameters. It is concluded, that also in hypertensive patients with diminished renal function felodipine exerts a potentially advantageous natriuretic effect. However, this natriuretic effect is possibly less at lower GFR and seems to be attenuated by blood pressure reduction. The mechanism of this natriuretic effect as well as its contribution to the antihypertensive effect of felodipine still has to be clarified.
F T Huysmans; H W van Hamersvelt; H E Sluiter; J F Wetzels; R A Koene
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international. Supplement     Volume:  36     ISSN:  0098-6577     ISO Abbreviation:  Kidney Int. Suppl.     Publication Date:  1992 May 
Date Detail:
Created Date:  1992-07-27     Completed Date:  1992-07-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7508622     Medline TA:  Kidney Int Suppl     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S106-9     Citation Subset:  IM    
Department of Medicine, Sint Radboud Hospital, University of Nijmegen, The Netherlands.
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MeSH Terms
Blood Pressure / drug effects
Felodipine / administration & dosage,  therapeutic use*
Glomerular Filtration Rate / drug effects
Hypertension, Renal / drug therapy*,  physiopathology
Infusions, Intravenous
Middle Aged
Natriuresis / drug effects
Renal Circulation / drug effects
Vascular Resistance / drug effects
Reg. No./Substance:

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