Calcium antagonists and the kidney

Calcium antagonists have evolved as an important class of cardiovascular therapeutic agents. Usefulness in treating hypertension, angina pectoris, and cardiac arrhythmias has been established. Investigations show that calcium antagonists have a role in altering renal functions. They are natriuretic and may benefit salt-sensitive hypertensives. They have been shown to block vasoconstriction of the afferent arteriole in the presence of constrictors such as endothelin, thromboxane, norepinephrine, and angiotensin II. These vasoconstrictors may be mediators of nephrotoxins such as radiocontrast agents, and cyclosporine A. Actions of calcium antagonists which are being investigated for potential benefit in ameliorating chronic renal disease include: preventing glomerular hypertrophy, blocking angiotensin II-mediated macromolecule entry into mesangial cells and cytokine release, free-radical scavenger activity, and decreasing calcium deposition within the kidney. Slowing the progression of renal disease with the calcium antagonists has been demonstrated in both short- and long-term trials. Further studies are currently underway.