Related Experiment Video

Updated: Jun 28, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Potential risks of calcium channel blockers in chronic kidney disease

Karen A Griffin1, Anil K Bidani

  • 1Department of Medicine, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. kgriffi@lumc.edu

Current Cardiology Reports
|October 28, 2008
PubMed

Insights

Calcium channel blockers (CCBs) are less effective for slowing chronic kidney disease (CKD) progression in proteinuric nephropathies unless normotension is achieved. Careful monitoring is essential when using CCBs for blood pressure control in CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Antihypertensive therapy is crucial for slowing chronic kidney disease (CKD) progression.
  • Proteinuric nephropathies involve hypertensive injury primarily at the glomerular capillaries.
  • Calcium channel blockers (CCBs) may impair renal autoregulation, affecting glomerular protection.

Purpose of the Study:

  • To evaluate the efficacy of CCBs in proteinuric nephropathies.
  • To compare the renoprotective effects of CCBs versus other antihypertensives.
  • To understand the role of CCBs in managing hypertension in CKD patients.

Main Methods:

  • Comparative analysis of antihypertensive strategies in proteinuric nephropathies.
  • Assessment of CCB effects on renal autoregulation and glomerular pressure.
  • Review of cardiovascular and end-stage renal disease risks in CKD patients.

Main Results:

  • CCBs are less effective than other antihypertensives in proteinuric nephropathies without achieving normotension.
  • CCBs may impair renal autoregulation, increasing glomerular capillary vulnerability.
  • Renin-angiotensin system blockade shows greater renoprotection, potentially due to BP-independent mechanisms.

Conclusions:

  • CCBs' renoprotective inferiority in proteinuric nephropathies is linked to impaired renal autoregulation.
  • CKD patients face a higher absolute risk of cardiovascular events than end-stage renal disease.
  • CCBs can be considered for BP reduction in CKD if other agents fail, requiring careful monitoring of BP, proteinuria, and disease progression.

Related Concept Videos

Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Antihypertensive Drugs: Action of Calcium Channel Blockers01:18

Antihypertensive Drugs: Action of Calcium Channel Blockers

Calcium ions are essential to contract smooth muscle cells in blood vessels. They enter these cells through voltage-dependent calcium channels, specifically L-type calcium channels in the cell membrane. These L-type calcium channels are integral to the excitation-contraction coupling process in smooth muscle. When a stimulus is received by smooth muscle cells, their membrane depolarizes. This alteration in membrane potential instigates the opening of L-type calcium channels. As a result,...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...