ISSN:
1573-7241
Keywords:
nisoldipine
;
chronic renal failure
;
kidneys
;
glomerular filtration
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary Chronic renal failure (CRF) patients with a stable course were asked to participate in a follow-up program in which they were randomized into two groups: 1) the placebo group taking their standard antihypertensive therapy without any calcium ion blocker: and 2) the nisoldipine group, those patients taking the calcium channel blocker nisoldipine as the only antihypertensive drug. The two groups had similar blood pressures on entering the study (151±21.3/90.7±7.4 mmHg in the nisoldipine and 146.7±18/94±9.4 mmHg in the placebo group). Their protein intake was also similar (daily average throughout the follow-up period: 0.83±0.18 g protein per kg body weight in the nisoldipine and 0.9±0.12 g in the placebo group). The patients were checked monthly. The follow-up averaged 11.1±4.8 months in the nisoldipine group and 13.7±4.2 months in the placebo group. The rate of progression of CRF, as expressed by the slope of the regression line of 1/serum creatinine versus time, decreased in the nisoldipine group from the initial (−8.03±4.91)×10−3 to (−5.57±5)×10−3) (two-tailed P-test=0.016) after intervention. The slopes tended to become steeper in the placebo group, with an initial slope of (−4.1±3.2)10−3 changing to (−7.9±5)×10−3 after intervention. This difference did not reach statistical significance (two-tailed P=0.072). The rate of progression of CRF decreased in 12 of 14 patients in the nisoldipine-treated group versus 3 of 11 patients in the placebo group. The decrease in blood pressure in the two groups was similar and statistically significant but was clinically of marginal importance (mean blood pressure in the nisoldipine-treated group were 111.4±11.7 mmHg before and 105.9±8.6 mmHg after intervention, and in the placebo group mean blood pressure was 110±12.8 mmHg before and 103.8±10.3 mmHg after intervention). The calcium ion blocker nisoldipine may be of benefit in slowing down the progression of CRF in patients who are already on protein restriction and whose blood pressure is adequately treated. However, in view of the different initial severity of renal failure in the two randomized groups with higher initial regression slope in the nisoldipine group, further studies are required to confirm these preliminary findings.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF02125735
Permalink
