Effect of Efonidipine on Proteinuria in Patients with Chronic Kidney Disease Receiving RAS Blockade.
- Author:
Jung Kook WI
1
;
Kyung Whan JEONG
;
Tae Won LEE
;
Sang Ho LEE
;
Ju Young MOON
;
Dae Ryong CHA
;
Sung Kyu HA
;
Soon Bae KIM
;
Ihm Soo KWAK
;
Chun Gyoo IHM
Author Information
1. Deparyment of Nephrology, College of Medicine, Kyunghee University, Seoul, Korea. cgihm@yahoo.co.kr
- Publication Type:Original Article ; Clinical Trial
- Keywords:
Calcium channel blocker;
Efonidipine;
Amlodipine;
Proteinuria
- MeSH:
Amlodipine;
Angiotensin-Converting Enzyme Inhibitors;
Blood Pressure;
Calcium Channels, L-Type;
Creatinine;
Cross-Over Studies;
Dihydropyridines;
Female;
Humans;
Hypertension;
Male;
Nitrophenols;
Organophosphorus Compounds;
Proteinuria;
Renal Insufficiency, Chronic;
Sample Size
- From:Korean Journal of Nephrology
2010;29(3):322-328
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Efonidipine, which inhibits both T- and L-type calcium channels, has been shown to be effective in reducing proteinuria and preserve renal function. This study was conducted to compare the effects of efonidipine versus amlodipine on the management of hypertension and proteinuria in patients with chronic kidney disease (CKD) receiving ACE inhibitors or ARB. METHODS: This study included 41 CKD patients who were at stages 2-4 and had a urine spot protein/ creatinine ratio of >0.5. Patients were administered amlodipine (5 mg/day) and efonidipine (40 mg/ day) for 3 months in a cross-over design. Blood pressure and spot urine protein/creatinine ratio were compared before and after the cross-over treatment. RESULTS: There were 24 male patients and 17 female patients. The mean age of the patients was 55.9+/-12.9 years. When the patients' medication was changed to eponidifine, we obtained the following results. First, there were no significant changes in blood pressure and serum creatinine. Second, the urine spot protein/creatinine ratio was significantly decreased (before the cross-over, 2.9+/-2.6; after the cross-over, 2.3+/-1.9 g/g; p=0.02). Finally, the reduction rate of proteinuria was significantly higher in patients with CKD at stages 2-3 than in those with CKD at stage 4 after the cross-over (stage 2, - 26.1%; stage 3, -17%; stage 4, +12.8%; p=0.03). CONCLUSION: It is concluded that efonidipine may significantly decrease proteinuria compared with amlodipine in CKD patients receiving ACE inhibitors or ARB. Further double-blind clinical trials with a larger sample size are needed to confirm our results.
