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Influence of T-calcium channel blocker treatment on deterioration of renal function in chronic kidney disease

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An Erratum to this article was published on 27 September 2009

Abstract

Some calcium channel blockers (CCBs) have renoprotective effects. Our aim was to compare the effects of different subclasses of CCBs on the deterioration of renal function in chronic kidney disease (CKD). This is a prospective, observational cohort study in a single center. The subjects were 107 nondiabetic CKD patients. The rate of deterioration of estimated glomerular filtration rate (ΔeGFR) was calculated by [last visit eGFR — baseline eGFR/follow-up duration]. Multivariate analysis was performed using the change in urinary protein (ΔUP) and ΔeGFR during follow-up as response variables. CCB subclasses were L-type in 76 patients, T- and L-type in 28 patients, and nondihydropyridines in 6 patients. Multiregression analysis indicated that higher baseline proteinuria (UP) and the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers were associated with the decrease of UP, while the use of L-type CCBs, prednisolone, and probucol was associated with the increase of UP. The use of T- and L-type CCBs, ACEIs and diuretics was associated with a good outcome in terms of ΔeGFR, whereas chronic glomerulonephritis, polycystic kidney disease, and higher baseline eGFR and UP were associated with a poor outcome. It is suggested that the use of T- and L-type CCB among other subclasses may improve the outcome of patients with nondiabetic CKD in terms of renal function.

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References

  1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296–1305

    Article  CAS  PubMed  Google Scholar 

  2. Ruggenenti P, Perna A, Mosconi L, Pisoni R, Remuzzi G (1998) Urinary protein excretion rate is the best independent predictor of ESRF in non-diabetic proteinuric chronic nephropathies. Kidney Int 53:1209–1216

    Article  CAS  PubMed  Google Scholar 

  3. Bakris GL, Williams M, Dworkin L, Elliott WJ, Epstein M, Toto R, Tuttle K, Douglas J, Hsue W, Sowers J (2000) National kidney foundation hypertension and diabetes executive committees working group: Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis 36:646–661

    CAS  PubMed  Google Scholar 

  4. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulman NB, Stamler J (1996) Blood pressure and end-stage renal disease in men. N Engl J Med 334:13–18

    Article  CAS  PubMed  Google Scholar 

  5. Jafar TH, Stark PC, Schmid CH, Landa M, Maschio G, de Jong PE, de Zeeuw D, Shahinfar S, Toto R, Levey AS; AIPRD Study Group (2003) Progression of chronic kidney disease: the role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition, a patient-level meta-analysis. Ann Intern Med 139:244–252

    CAS  PubMed  Google Scholar 

  6. Peterson JC, Adler S, Burkart JM, Greene T, Hebert LA, Hunsicker LG, King AJ, Klahr S, Massry SG, Seifter JL (1995) Blood pressure control, proteinuria, and the progression of renal disease. The Modification of Diet in Renal Disease Study. Ann Intern Med 123:754–762

    CAS  PubMed  Google Scholar 

  7. Swales P, Williams B (2002) Calcium channel blockade in combination with angiotensin-converting enzyme inhibition or angiotensin II (AT(1)-receptor) antagonism in hypertensive diabetics and patients with renal disease and hypertension. J Renin Angiotensin Aldosterone Syst 3:79–89

    Article  CAS  PubMed  Google Scholar 

  8. Sica D (2004) Calcium channel blockers and the kidney. Clin Cornerstone 6:39–52

    Article  PubMed  Google Scholar 

  9. Fogari R, Corradi L, Zoppi A, Lazzari P, Mugellini A, Preti P, Rinaldi A (2007) Addition of manidipine improves the antiproteinuric effect of candesartan in hypertensive patients with type II diabetes and microalbuminuria. Am J Hypertens 20:1092–1096

    Article  CAS  PubMed  Google Scholar 

  10. Ohishi M, Takagi T, Ito N, Terai M, Tatara Y, Hayashi N, Shiota A, Katsuya T, Rakugi H, Ogihara T (2007) Renal-protective effect of T-and L-type calcium channel blockers in hypertensive patients: an Amlodipine-to-Benidipine Changeover (ABC) study. Hypertens Res 30:797–806

    Article  CAS  PubMed  Google Scholar 

  11. Tsuchihashi T, Ueno M, Tominaga M, Kajioka T, Onaka U, Eto K, Goto K (2005) Anti-proteinuric effect of an N-type calcium channel blocker, cilnidipine. Clin Exp Hypertens 27:583–591

    Article  CAS  PubMed  Google Scholar 

  12. Norris K, Vaughn C (2003) The role of renin-angiotensin-aldosterone system inhibition in chronic kidney disease. Expert Rev Cardiovasc Ther 1:51–63

    Article  CAS  PubMed  Google Scholar 

  13. Vog TL, Kocks MJ, Navis G (2004) Renoprotection by blockade of the renin-angiotensin-aldosterone system in diabetic and non-diabetic chronic kidney disease. Specific involvement of intra-renal angiotensin-converting enzyme activity in therapy resistance? Minerva Med 95:395–409

    Google Scholar 

  14. Ruggenenti P (2004) Angiotensin-converting enzyme inhibition and angiotensin II antagonism in nondiabetic chronic nephropathies. Semin Nephrol 24:158–167

    Article  CAS  PubMed  Google Scholar 

  15. Ginsberg JM, Chang BS, Matarese RA, Garella S (1983) Use of single voided urine samples to estimate quantitative proteinuria. N Engl J Med 309:1543–1546

    CAS  PubMed  Google Scholar 

  16. Imai E, Matsuo S, Makino H, Watanabe T, Akizawa T, Nitta K, Iimuro S, Ohashi Y, Hishida A; CKD-JAC Study Group (2008) Chronic Kidney Disease Japan Cohort (CKD-JAC) study: design and methods. Hypertens Res 31:1101–1107

    Article  PubMed  Google Scholar 

  17. Hayashi K, Ozawa Y, Fujiwara K, Wakino S, Kumagai H, Saruta T (2003) Role of actions of calcium antagonists on efferent arterioles — with special references to glomerular hypertension. Am J Nephrol 23:229–244

    Article  CAS  PubMed  Google Scholar 

  18. Hayashi K, Wakino S, Sugano N, Ozawa Y, Homma K, Saruta T (2007) Ca2+ channel subtypes and pharmacology in the kidney. Circ Res 100:342–353

    Article  CAS  PubMed  Google Scholar 

  19. Furukawa T, Nukada T, Miura R, Ooga K, Honda M, Watanabe S, Koganesawa S, Isshiki T (2005) Differential blocking action of dihydropyridine Ca2+ antagonists on a T-type Ca2+ channel (alpha1G) expressed in Xenopus oocytes. J Cardiovasc Pharmacol 45:241–246

    Article  CAS  PubMed  Google Scholar 

  20. Segura J, Garcia-Donaire JA, Ruilope LM (2005) Calcium channel blockers and renal protection: insights from the latest clinical trials. J Am Soc Nephrol 16(Suppl 1):S64–S66

    Article  CAS  PubMed  Google Scholar 

  21. Wright JT Jr, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, Cheek D, Douglas-Baltimore JG, Gassman J, Glassock R, Hebert L, Jamerson K, Lewis J, Phillips RA, Toto RD, Middleton JP, Rostand SG; African American Study of Kidney Disease and Hypertension Study Group (2002) Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA 288: 2421–2431

    Article  CAS  PubMed  Google Scholar 

  22. Jerums G, Allen TJ, Campbell DJ (2001) Long-term comparison between perindopril and nifedipine in normotensive patients with type 1 diabetes and microalbuminuria. Am J Kidney Dis 37: 890–899

    Article  CAS  PubMed  Google Scholar 

  23. Ishimitsu T, Kameda T, Akashiba A, Takahashi T, Ohta S, Yoshii M, Minami J, Ono H, Numabe A, Matsuoka H (2007) Efonidipine reduces proteinuria and plasma aldosterone in patients with chronic glomerulonephritis. Hypertens Res 30:621–626

    Article  CAS  PubMed  Google Scholar 

  24. Yuan Z, Kishimoto C, Shioji K (2003) Beneficial effects of low-dose benidipine in acute autoimmune myocarditis: suppressive effects on inflammatory cytokines and inducible nitric oxide synthase. Circ J 67:545–550

    Article  CAS  PubMed  Google Scholar 

  25. Tsuda K (2008) Electron paramagnetic response investigation on modulatory effect of benidipine on membrane fluidity of erythrocytes in essential hypertension. Heart Vessels 23:134–139

    Article  PubMed  Google Scholar 

  26. Ozawa Y, Hayashi K, Nagahama T, Fujiwara K, Saruta T (2001) Effect of T-type selective calcium antagonist on renal microcirculation; studies in the isolated perfused hydronephrotic kidney. Hypertension 38:343–347

    CAS  PubMed  Google Scholar 

  27. Fujiwara K, Kanno Y, Hayashi K, Takenaka T, Saruta T (1999) Renal effects of efonidipine hydrochloride, a new calcium antagonist, in spontaneously hypertensive rats with glomerular injury. Clin Exp Pharmacol Physiol 26:674–679

    Article  Google Scholar 

  28. Konda T, Enomoto A, Matsushita J, Takahara A, Moriyama T (2005) The N- and L-type calcium channel blocker cilnidipine suppresses renal injury in dahl rats fed a high-sucrose diet, an experimental model of metabolic syndrome. Nephron Physiol 101:1–13

    Article  Google Scholar 

  29. Shiga T, Yamada Y, Matsuda N, Tanaka T, Urae A, Hashiguchi M, Hagiwara N, Kasanuki H (2007) Influence of cilnidipine or nisoldipine on sympathetic activity in healthy male subjects. Heart Vessels 22:404–409

    Article  PubMed  Google Scholar 

  30. Fujita T, Ando K, Nishimura H, Ideura T, Yasuda G, Isshiki M, Takahashi K (2007) Cilnidipine versus Amlodipine Randomised Trial for Evaluation in Renal Disease (CARTER) Study Investigators: antiproteinuric effect of the calcium channel blocker cilnidipine added to renin-angiotensin inhibition in hypertensive patients with chronic renal disease. Kidney Int 72:1543–1549

    Article  CAS  PubMed  Google Scholar 

  31. Zucchelli P, Zuccalá A (1998) Progression of renal failure and hypertensive nephrosclerosis. Kidney Int Suppl 68:S55–S59

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Internal Medicine Department, Yoshikawa Hospital, Yamagata, Japan

    Kiyotsugu Omae

  2. Department of Medicine, Kidney Center, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Kiyotsugu Omae, Tetsuya Ogawa & Kosaku Nitta

Authors
  1. Kiyotsugu Omae
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  2. Tetsuya Ogawa
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  3. Kosaku Nitta
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Corresponding author

Correspondence to Tetsuya Ogawa.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00380-009-1191-9

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Omae, K., Ogawa, T. & Nitta, K. Influence of T-calcium channel blocker treatment on deterioration of renal function in chronic kidney disease. Heart Vessels 24, 301–307 (2009). https://doi.org/10.1007/s00380-008-1125-y

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  • DOI: https://doi.org/10.1007/s00380-008-1125-y

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