Calcium channel blockers and renal dysfunction in arterial hypertension

Beside effective systemic blood pressure control, calcium channel blockers exert several effects on glomerular haemodynamics (namely, preglomerular vasodilatation at the early stage of the hypertensive process) and on cellular mechanisms of glomerular sclerosis (namely, inhibition of mesangial mechanisms of growth) that may provide a renal protective effect in patients with essential hypertension and, in turn, may prevent or attenuate the development of nephrosclerosis (Table 3). However, up to now, there have been relatively few attempts to corroborate this assumption in clinical practice. Furthermore, more clinical studies have been conducted with the dihydropiridine class of calcium channel blockers. Thus, prospective, long-term ongoing studies will help to delineate the long-range consequences of the renal actions of the different class of calcium channel blockers in essential hypertension.