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Calcium antagonists and renal failure progression

Nicolás Roberto Robles1

  • 1Hospital Infanta Cristina, Badajoz, Spain. nroblesp@senefro.org

Renal Failure
|March 20, 2008
PubMed

Insights

Newer calcium antagonists show promise in protecting kidneys from chronic renal failure. These drugs, including manidipine and lercanidipine, may reduce proteinuria and microalbuminuria, offering nephroprotective effects.

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiovascular Medicine

Background:

  • While tight blood pressure control is key for chronic renal failure, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers offer organ protection.
  • The specific renal effects of calcium antagonists are less defined, despite their potential pleiotropic kidney-protective actions.

Purpose of the Study:

  • To explore the nephroprotective mechanisms and clinical renal effects of calcium antagonists, particularly newer dihydropyridinic agents.
  • To evaluate the role of specific calcium antagonists like manidipine and lercanidipine in managing renal disease and proteinuria.

Main Methods:

  • Review of existing evidence on calcium antagonists' effects on kidney physiology.
  • Analysis of studies investigating the impact of manidipine and lercanidipine on proteinuria and microalbuminuria, including combination therapy.

Main Results:

  • Calcium antagonists exhibit pleiotropic effects, including attenuating mesangial entrapment, counteracting growth factor effects, and suppressing mesangial cell proliferation.
  • Newer dihydropyridinic calcium antagonists may decrease filtration fraction, offering nephroprotection comparable to renin-angiotensin axis blockers.
  • Manidipine and lercanidipine show potential in reducing proteinuria and microalbuminuria, with lercanidipine demonstrating efficacy in combination therapy.

Conclusions:

  • Newer calcium antagonists possess distinct nephroprotective properties beyond blood pressure reduction.
  • Manidipine and lercanidipine represent promising therapeutic options for patients with chronic renal failure, particularly in reducing proteinuria and microalbuminuria.

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