Document Detail

Effects of sodium intake on albumin excretion in patients with diabetic nephropathy treated with long-acting calcium antagonists.
MedLine Citation:
PMID:  8686978     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether sodium intake alters albumin excretion in patients with nephropathy from non-insulin-dependent diabetes mellitus who were treated with two different long-acting calcium antagonists. DESIGN: Prospective, crossover, open-label trial. SETTING: Rush-Presbyterian-St. Luke's Medical Center. PATIENTS: 9 men and 6 women (mean age +/- SD, 56 +/- 8 years) with non-insulin-dependent diabetes mellitus, hypertension, renal insufficiency, and macroalbuminuria. INTERVENTION: Diltiazem (mean dose, 392 +/- 27 mg/d) or nifedipine (mean dose, 83 +/- 9 mg/d) was used to decrease blood pressure to less than 140/90 mm Hg. All patients also received furosemide concomitantly for blood pressure control. RESULTS: Blood pressure reduction with once-daily diltiazem decreased urine albumin excretion (2967 +/- 784 mg/d at baseline compared with 1294 +/- 679 mg/d after diltiazem therapy; P < 0.05) at 4 weeks while patients received a diet consisting of 50 mEq of sodium per day. Albumin excretion did not decrease when sodium intake was increased to 250 mEq/d, and blood pressure was reduced to levels similar to those seen with the low-sodium diet. Similar blood pressure reduction with once-daily nifedipine did not significantly alter albumin excretion regardless of sodium intake. CONCLUSION: Sodium intake affects the albumin-decreasing effects of certain calcium antagonists. Recent studies suggest that antihypertensive medications that reduce albumin excretion and arterial pressure correlate with reduced renal mortality compared with medications that do not have albumin-decreasing effects. Thus, a low-sodium diet should be prescribed to maximize the albumin-decreasing effects of certain calcium antagonists.
G L Bakris; A Smith
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of internal medicine     Volume:  125     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-08-19     Completed Date:  1996-08-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  201-4     Citation Subset:  AIM; IM    
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
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MeSH Terms
Albuminuria / drug therapy*
Antihypertensive Agents / therapeutic use*
Calcium Channel Blockers / therapeutic use*
Clonidine / therapeutic use
Cross-Over Studies
Diabetic Nephropathies / urine*
Diltiazem / therapeutic use
Middle Aged
Nifedipine / therapeutic use
Prospective Studies
Sodium, Dietary / administration & dosage,  pharmacology*
Reg. No./Substance:
0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Sodium, Dietary; 21829-25-4/Nifedipine; 4205-90-7/Clonidine; 42399-41-7/Diltiazem

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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