Effects of calcium antagonists in hypertensive patients with renal dysfunction: a prospective, randomized, parallel...

Although calcium antagonists, derived from dihydropyridine (DHP), are important agents in achieving control in a majority of patients with high blood pressure and renal disease, there are no comparative data regarding their inhibitory effects on the progression of renal dysfunction in Japan.

Benidipine and nifedipine retard both calcium antagonists derived from DHP and were compared in terms of their inhibitory effect on the progression of renal dysfunction in hypertensive patients. The primary end-points were defined as 1.5 times the serum creatinine value at baseline, progression to end-stage renal failure (ESRF) necessitating dialysis or renal transplantation, and death.

During the study period, a significant decline in blood pressure was observed in the two groups, with no significant difference between them. The worsening of nephropathy was significantly inhibited in the benidipine group as compared with the nifedipine retard group (log-rank test: P = 0.014, Wilcoxon's test: P = 0.022). Among the subjects who reached a primary end-point, one (33%) in the benidipine group and five (50%) in the nifedipine retard group were placed on haemodialysis within 1 year.

It appears that benidipine inhibits the progression of hypertensive renal diseases more effectively than nifedipine retard.