Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Usage Patterns and Outcomes by Dual Type Calcium Channel Blockers in Patients with Chronic Kidney Disease

만성 신장질환 환자에서 dual type calcium channel blocker의 사용 양상 및 결과 비교

  • Oh, Mi Ran (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Ahn, Hye Lim (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Choi, Sun (Catholic Medical Center Office of Human Research Protection) ;
  • La, Hyen Oh (College of Pharmacy, the Catholic University of Korea)
  • 오미란 (가톨릭대학교 서울성모병원 약제부) ;
  • 안혜림 (가톨릭대학교 서울성모병원 약제부) ;
  • 최선 (가톨릭중앙의료원 연구윤리사무국) ;
  • 나현오 (가톨릭대학교 약학대학)
  • Received : 2020.08.10
  • Accepted : 2020.12.12
  • Published : 2020.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Dual-type calcium channel blockers (CCBs), such as efonidipine and cilnidipine, are renoprotective drugs that reportedly reduce proteinuria by dilating afferent and efferent arterioles of the glomerulus. However, studies comparing the effect of dual-type CCB on proteinuria have not been conducted. Therefore, we aimed to compare the effect of dual-type CCB (efonidipine and cilnidipine) usage patterns in hypertensive patients with chronic kidney disease (CKD). Methods: This single-center, retrospective study included 53 patients with CKD who 1) initiated efonidipine or cilnidipine treatment while on a renin-angiotensin system inhibitor and 2) had received efonidipine or cilnidipine for at least one year. We compared usage patterns between the efonidipine and cilnidipine groups during the one-year period and analyzed the following outcomes: urinary protein-to-creatinine ratio, blood pressure, and serum creatinine. Results: The study included 25 patients in the efonidipine group and 28 patients in the cilnidipine group. In both groups, blood pressure and urinary protein-to-creatinine ratios tended to decrease; however, the change during each interval was not significant. Conclusions: In patients with CKD who were on renin-angiotensin system inhibitor therapy, the addition of a dual-type CCB (i.e., efonidipine or cilnidipine) tended to reduce proteinuria; however, the change during each interval was not significant.

Keywords

References

  1. Gansevoort RT, Matsushita K, van der Velde M, et al. Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts. Kidney Int 2011;80(1):93-104. https://doi.org/10.1038/ki.2010.531
  2. van der Velde M, Matsushita K, Coresh J, et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative metaanalysis of high-risk population cohorts. Kidney Int 2011;79(12):1341-52. https://doi.org/10.1038/ki.2010.536
  3. Hemmelgarn BR, Manns BJ, Lloyd A, et al. Relation between kidney function, proteinuria, and adverse outcomes. JAMA 2010;303(5):423-9. https://doi.org/10.1001/jama.2010.39
  4. Abe M, Maruyama N, Suzuki H, et al. L/N-type calcium channel blocker cilnidipine reduces plasma aldosterone, albuminuria, and urinary liver-type fatty acid binding protein in patients with chronic kidney disease. Heart Vessels 2013;28(4):480-9. https://doi.org/10.1007/s00380-012-0274-1
  5. Uchida S, Takahashi M, Sugawara M, et al. Effects of the N/L-type calcium channel blocker cilnidipine on nephropathy and uric acid metabolism in hypertensive patients with chronic kidney disease (JCIRCLE study). J Clin Hypertens (Greenwich) 2014;16(10):746-53. https://doi.org/10.1111/jch.12412
  6. Koshy S, Bakris GL. Therapeutic approaches to achieve desired blood pressure goals: focus on calcium channel blockers. Cardiovasc Drugs Ther 2000;14(3):295-301. https://doi.org/10.1023/A:1007882624572
  7. Hayashi K, Ozawa Y, Fujiwara K, Wakino S, Kumagai H, Saruta T. Role of actions of calcium antagonists on efferent arterioles with special references to glomerular hypertension. Am J Nephrol 2003;23(4):229-44. https://doi.org/10.1159/000072054
  8. Ertel EA, Campbell KP, Harpold MM, et al. Nomenclature of voltage-gated calcium channels. Neuron 2000;25(3):533-5. https://doi.org/10.1016/S0896-6273(00)81057-0
  9. Hayashi K, Wakino S, Sugano N, Ozawa Y, Homma K, Saruta T. Ca2+ channel subtypes and pharmacology in the kidney. Circ Res 2007;100(3):342-53. https://doi.org/10.1161/01.RES.0000256155.31133.49
  10. Griffin KA, Picken MM, Bakris GL, Bidani AK. Class differences in the effects of calcium channel blockers in the rat remnant kidney model. Kidney Int 1999;55(5):1849-60. https://doi.org/10.1046/j.1523-1755.1999.00434.x
  11. Griffin KA, Picken M, Bidani AK. Method of renal mass reduction is a critical modulator of subsequent hypertension and glomerular injury. J Am Soc Nephrol 1994;4(12):2023-31. https://doi.org/10.1681/ASN.V4122023
  12. Griffin KA, Picken MM, Bidani AK. Deleterious effects of calcium channel blockade on pressure transmission and glomerular injury in rat remnant kidneys. J Clin Invest 1995;96(2):793-800. https://doi.org/10.1172/JCI118125
  13. Bidani AK, Schwartz MM, Lewis EJ. Renal autoregulation and vulnerability to hypertensive injury in remnant kidney. Am J Physiol 1987;252(6 Pt 2):F1003-10.
  14. Catterall WA. Structure and regulation of voltage-gated Ca2+ channels. Annu Rev Cell Dev Biol 2000;16:521-55. https://doi.org/10.1146/annurev.cellbio.16.1.521
  15. Ishimitsu T, Kameda T, Akashiba A, et al. Efonidipine reduces proteinuria and plasma aldosterone in patients with chronic glomerulonephritis. Hypertens Res 2007;30(7):621-6. https://doi.org/10.1291/hypres.30.621
  16. Kanaoka T, Tamura K, Wakui H, et al. L/N-type calcium channel blocker cilnidipine added to renin-angiotensin inhibition improves ambulatory blood pressure profile and suppresses cardiac hypertrophy in hypertension with chronic kidney disease. Int J Mol Sci 2013;14(8):16866-81. https://doi.org/10.3390/ijms140816866
  17. Wi JK, Jeong KW, Lee TW et al. Effect of efonidipine on proteinuria in patients with chronic kidney disease receiving RAS blockade. Kidney Res Clin Pract 2010;29(3):322-8.