Document Detail


Antiproteinuric effect of the calcium channel blocker cilnidipine added to renin-angiotensin inhibition in hypertensive patients with chronic renal disease.
MedLine Citation:
PMID:  17943080     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cilnidipine, a dual L-/N-type calcium channel blocker, dilates both efferent and afferent arterioles and is renoprotective. Our multi-center, open-labeled, and randomized trial compared the antiproteinuric effect of cilnidipine with that of amlodipine in hypertensive patients with kidney disease. A group of 339 patients, already receiving renin-angiotensin system inhibitor treatment, were randomly assigned to cilnidipine or amlodipine. The primary endpoint was a decrease in the urinary protein to creatinine ratio. After 1-year of treatment, systolic and diastolic blood pressures were significantly reduced in both groups which did not differ between them. The urinary protein to creatinine ratio significantly decreased in the cilnidipine compared to the amlodipine group. Cilnidipine exerted a greater antiproteinuric effect than amlodipine even in the subgroup whose blood pressure fell below the target level. This study suggests that cilnidipine is superior to amlodipine in preventing the progression of proteinuria in hypertensive patients when coupled with a renin-angiotensin system inhibitor.
Authors:
T Fujita; K Ando; H Nishimura; T Ideura; G Yasuda; M Isshiki; K Takahashi;
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2007-10-17
Journal Detail:
Title:  Kidney international     Volume:  72     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-29     Completed Date:  2008-01-31     Revised Date:  2009-06-30    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1543-9     Citation Subset:  IM    
Affiliation:
Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan. fujita-dis@h.u-tokyo.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Amlodipine / administration & dosage,  adverse effects
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Blood Pressure / drug effects
Calcium Channel Blockers / administration & dosage*,  adverse effects
Cardiovascular Diseases / mortality
Creatinine / blood
Dihydropyridines / administration & dosage*,  adverse effects
Drug Therapy, Combination
Female
Heart Rate / drug effects
Humans
Hypertension, Renal / drug therapy*
Male
Middle Aged
Proteinuria / drug therapy*
Renal Insufficiency, Chronic / drug therapy*
Renin-Angiotensin System / drug effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Calcium Channel Blockers; 0/Dihydropyridines; 132203-70-4/cilnidipine; 60-27-5/Creatinine; 88150-42-9/Amlodipine
Comments/Corrections
Comment In:
Kidney Int. 2009 Jul;76(2):230-1   [PMID:  19564858 ]
Kidney Int. 2008 May;73(9):1095; author reply 1095-6   [PMID:  18414444 ]

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