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Updated: Mar 28, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Use of Calcium Channel Blockers is Associated with Mortality in Patients with Chronic Kidney Disease
Dominik G Haider1, Thomas Sauter, Gregor Lindner
1Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.
Insights
Calcium channel blockers, unlike other antihypertensive drugs, are linked to increased mortality risk in patients with chronic kidney disease (CKD). This finding is crucial for managing hypertension in CKD patients.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Antihypertensive medications reduce adverse outcomes in chronic kidney disease (CKD).
- No specific antihypertensive drug class is recommended for CKD patients due to differing pharmacodynamics.
- Understanding drug-specific survival associations in CKD is critical.
Purpose of the Study:
- To analyze the association between different classes of antihypertensive medicines and survival in patients with chronic kidney disease (CKD).
Main Methods:
- A cohort of 606 CKD patients with available medical therapy data was selected from 2687 kidney biopsy patients.
- Glomerular filtration rate (GFR) assessed kidney function at biopsy.
- Mortality was the primary outcome variable.
Main Results:
- 114 (18.7%) patients died during the study period.
- Univariate analysis linked alpha-blockers, calcium channel antagonists, disease progression, diabetes mellitus (DM) types 1 and 2, arterial hypertension, coronary heart disease, peripheral vascular disease, male sex, and age to mortality.
- Multivariate Cox regression identified calcium channel blockers (HR 1.89), age (HR 1.04), DM type 1 (HR 8.43), DM type 2 (HR 2.17), and chronic obstructive pulmonary disease (HR 1.66) as significantly associated with mortality (p < 0.05).
Conclusions:
- Calcium channel blocker use, but not other antihypertensive drug classes, is associated with increased mortality in CKD patients, particularly those with glomerulonephritis (GN).
- These findings highlight the need for careful consideration of antihypertensive drug selection in CKD management.
Background/Aims:
The use of antihypertensive medicines has been shown to reduce proteinuria, morbidity, and mortality in patients with chronic kidney disease (CKD). A specific recommendation for a class of antihypertensive drugs is not available in this population, despite the pharmacodynamic differences. We have therefore analysed the association between antihypertensive medicines and survival of patients with chronic kidney disease.
Methods:
Out of 2687 consecutive patients undergoing kidney biopsy a cohort of 606 subjects with retrievable medical therapy was included into the analysis. Kidney function was assessed by glomerular filtration rate (GFR) estimation at the time point of kidney biopsy. Main outcome variable was death.
Results:
Overall 114 (18.7%) patients died. In univariate regression analysis the use of alpha-blockers and calcium channel antagonists, progression of disease, diabetes mellitus (DM) type 1 and 2, arterial hypertension, coronary heart disease, peripheral vascular disease, male sex and age were associated with mortality (all p<0.05). In a multivariate Cox regression model the use of calcium channel blockers (HR 1.89), age (HR 1.04), DM type 1 (HR 8.43) and DM type 2 (HR 2.17) and chronic obstructive pulmonary disease (HR 1.66) were associated with mortality (all p < 0.05).
Conclusion:
The use of calcium channel blockers but not of other antihypertensive medicines is associated with mortality in primarily GN patients with CKD.
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