Calcium channel blockers. Progression of renal disease

Once initiated, chronic renal disease inexorably progresses to end stage. Recent studies of various experimental renal disorders have shown that normalization of glomerular capillary flow and pressure, either by restricting protein intake or by administering converting enzyme inhibitors, slows this progression. Because the hemodynamic actions of Ca2+ channel blockers modify the angiotensin II-induced renal changes, these drugs have the potential for altering the course of renal disorders. These agents also protect the kidney from ischemic injury and nephrocalcinosis and reduce platelet aggregation, which can further contribute to the preservation of renal function. The published studies regarding the role of Ca2+ channel blockers in chronic renal disease, however, do not allow drawing firm conclusions. The effect of these agents might depend on the nature of renal disease and the drug and dose used. Controlled trials are needed before these drugs can be recommended for preservation of renal function.