DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20174388

Role of antihypertensives drugs on proteinuria in patients with chronic kidney disease and hypertension

Ritu Bala, Harminder Singh, . Rupali, Kuhu Verma

Abstract


Background: Hypertension is the most prevalent cardiovascular disease and the relevant data suggest that the burden, risk factors and co-morbidities associated with the essential hypertension is increasing with every passing day. It is one of the major chronic diseases resulting in high mortality and morbidity in today’s world. Aim: The aim of the study was to compare effects of cilnidipine and amlodipine on the blood pressure (BP), heart rate and proteinuria among patients of hypertension with chronic kidney disease.

Methods: 100 patients were included in this study. Patients were randomly assigned into two groups Group A and Group B (50 each). Group A: Patients received Cilnidipine (5-10mg/day). Group B: Patients received amlodipine (5-10mg/day).

Results: No significant difference in SBP, DBP, MBP and proteinuria while comparing both the groups of patients taking cilnidipine and amlodipine at baseline i.e. 0 to 12 week, 12 to 24 weeks and 0 to 24 weeks. Cilnidipine caused decrease in HR 0 to 12 week (p value 0.001), 12 to 24 weeks (p value 0.001) and 0 to 24 weeks (p value 0.0001). Amlodipine had increased heart rate from baseline to 12 weeks (p value 0.0001), 12 to 24 weeks (p value 0.051) and 0 to 24 weeks (p value 0.001). No significant difference was seen in any biochemical readings.

Conclusions: There was a significant change in all the parameters including BP, heart rate, proteinuria and other biochemical tests when they compared within the group but no significant difference while comparing both the groups.


Keywords


Amlodipine, Cilnidipine, Hypertension, Proteinuria

Full Text:

PDF

References


Chobanian AV, Bakris GL, Black HR. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206-52.

Theodore AK, Hypertensive vascular disease, Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J editors. In: Harrison’s Principles of Internal Medcine.18th Ed. McGraw-Hill; 2012:2042-2059.

Sever P, Beevers G, Bulpitt C. Management guidelines in essential hypertension: report of the second working party of the British Hypertension Society. BMJ. 1993;306:983-7.

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2013:284-427.

Medicines adherence’ (NICE clinical guideline 76, 2009). Available at: www.nice.org.uk/guidance/CG76 Bulletin of the World Health Organization, 2001, 79 (4).

SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 1991;265(24):3255-64.

Charles EA. The Kidney. In: Robbins, Kumar, Cotran editors. Robbins‘s pathologic basis of disease, 8th Edition. Philadelphia, USA: W.B. Saunders; 2011:908-14.

Hoffman BB. Therapy of hypertension In: Brunton LL, Lazo JS, Parker KL editors. Goodman Gillman’s The Pharmacological Basis of Therapeutics. 12th Edition. New York; McGraw Hill; 2012:845-868.

Hoshide S. Comparison of the effects of cilnidipine and amlodipine on ambulatory blood pressure. Hypertens Res. 2005;28:1003-8.

Kojima S, Shida M, Yokoyama H. Comparison between cilnidipine and amlodipine besilate with respect to proteinuria in hypertensive patients with renal diseases. Hypertens Res. 2004;27:379-85.

Takahara A, Iwasaki H, Nakamura Y, Sugiyama A. Cardiac effects of L/N-type Ca2+ channel blocker cilnidipine in anesthetized dogs. Eur J Pharmacol. 2007;565:166-70.

Takahara A. Cilnidipine: a new generation ca channel blocker with inhibitory action on sympathetic neurotransmitter release. Cardiovasc Ther. 2009;27:124-39.

Abe M, Okada K, Maruyama N, Matsumoto S, Maruyama T, Fujita T et al. Benidipine reduces albuminuria and plasma aldosterone in mild-to-moderate stage chronic kidney disease with albuminuria. Hypertens Res. 2011;34:268-73.

Soeki T, Kitani M, Kusunose K, Yagi S, Taketani Y, Koshiba K et al. Renoprotective and antioxidant effects of cilnidipine in hypertensive patients. Hypertens Res. 2012;35:1058-62.

Ando K, Ueshima K, Tanaka S, Kosugi S, Sato T, Matsuoka H et al. Comparison of the Antialbuminuric Effects of L-/N-type and L-type Calcium Channel Blockers in Hypertensive Patients with Diabetes and Microalbuminuria: The Study of Assessment for Kidney Function by Urinary Microalbumin in Randomized (SAKURA) Trial. Int J Med Sci. 2013;10:1209-16.