Effects of calcium antagonists on glomerular hemodynamics and structure in experimental hypertension

The RK, DS, and UNX SHR rats are related models of progressive renal disease characterized by the presence of severe systemic hypertension and reduction in renal mass. In these models, glomerular injury is related to increased glomerular pressure and to kidney and glomerular hypertrophy. As summarized in Table 1, administration of a calcium antagonist reduces the prevalence of glomerular sclerosis in all three models. Calcium antagonists have many effects that might tend to reduce renal injury. Similar to the ACE inhibitors, they may reduce PGC, although a protective effect has been observed in some models despite persistence of marked glomerular capillary hypertension. Calcium antagonists also appear to inhibit compensatory renal growth. The observation that these drugs lessen injury in experimental hypertension has important implications for the treatment of patients with hypertension and renal disease. However, widespread use of calcium antagonists specifically to prevent kidney damage should await the results of controlled clinical trials.