[Investigation on the blood pressure-independent nephroprotective effect of nilvadipine in type 2 diabetics]

The nephroprotective effect of ACE inhibitors and AT1 blockers has been demonstrated in manystudies. In particular, the effect produced by AT1 blockers has been described as being blood pressure-independent. The nephroprotective effect has been inconsistently observed in calcium antagonists; at the same time, it is always pointed out that calcium antagonists improve albumin excretion through a blood pressure-lowering mechanism.

Up to now there was not enough data available on the nephroprotective effect of nilvadipine. The goal of this study was to study the blood pressure-independent effect of the calcium antagonist nilvadipine on glomerular and renal tubular insufficiency during a 48-week treatment in hypertensive type 2 diabetics. Tubular or glomerular insufficiency was characterized on the basis of tubular and glomerular proteinuria and classified accordingto severity.

Four of 24 patients showed an improvement in glomerular insufficiency after the 48-week treatment with a once-a-day dose of 16 mg nilvadipine. In 18 of the 24 patients, a progression in the disease was prevented. Renal tubular insufficiency was improved in 15 of 24 patients and progression in 20 of 24 patients was prevented. This nephroprotective effect on impaired tubular reabsorption, which has been ascribed to early damage in diabetic patients or as a possible prodromal stage of glomerular nephropathy in recent work, has not been observed in any other medicine.