Related Experiment Videos
Renal hemodynamic effects of candesartan in normal and impaired renal function in humans
1Groningen Institute for Drug Studies (GIDS), State University Hospital, Groningen, The Netherlands.
Insights
Candesartan cilexitil effectively lowers blood pressure in hypertensive patients. Multiple doses improved renal hemodynamics, showing benefits regardless of initial kidney function, suggesting potential long-term renoprotection.
Area of Science:
- Nephrology
- Pharmacology
- Cardiovascular Medicine
Background:
- Hypertension is a major risk factor for chronic kidney disease.
- Angiotensin II type I receptor antagonists are used to manage hypertension and protect kidneys.
- The renal hemodynamic effects of candesartan cilexitil in patients with varying degrees of renal impairment require further elucidation.
Purpose of the Study:
- To investigate the effects of candesartan cilexitil on blood pressure and renal hemodynamics in hypertensive patients with impaired renal function.
- To compare the effects of single-dose versus multiple-dose administration of candesartan cilexitil.
Main Methods:
- A study involving 17 hypertensive patients with diverse renal function severity.
- Administration of candesartan cilexitil (8 mg once daily) with single and five-day treatment protocols.
- Measurement of mean arterial pressure (MAP), effective renal plasma flow (ERPF), glomerular filtration rate (GFR), and filtration fraction (FF).
Main Results:
- Candesartan cilexitil significantly reduced MAP after both single and multiple doses (P < 0.02).
- Effective renal plasma flow (ERPF) increased, while filtration fraction (FF) decreased significantly (P < 0.02) after both dosing regimens.
- Initial GFR influenced the response to single-dose therapy, but these correlations disappeared after five days of treatment, indicating uniform renal vasodilation.
Conclusions:
- Multiple-dose candesartan cilexitil demonstrated a favorable renal hemodynamic profile in hypertensive patients, irrespective of baseline renal function.
- The drug effectively reduced blood pressure and improved renal blood flow without altering GFR.
- Further research is warranted to determine the long-term renoprotective potential of candesartan cilexitil.
Abstract:
The effects of angiotensin II type I receptor antagonist candesartan cilexitil, 8 mg once daily, were studied after single dose and after five days treatment in 17 hypertensive patients [median mean arterial pressure (MAP) 118 mm Hg, range 84 to 134] with renal function impairment of different severity [glomerular filtration rate (GFR) 60 ml/min, range 11 to 161]. The MAP fell by -8% (-14 to -5) and -11 (-16 to -5)% after single and multiple dose, respectively (both P < 0.02). Effective renal plasma flow (ERPF) increased by 13% (7 to 19) and 10% (3 to 14) after single and multiple dose, respectively (both P < 0.02), while the GFR did not change. Filtration fraction (FF) fell by -11% (-14 to -5) and -12% (-13 to -4) after single and multiple doses, respectively (both P < 0.02). After a single dose the % change in ERPF (r = 0.58) and FF (r = -0.52, both P < 0.05) positively correlated with pretreatment GFR, indicating a more pronounced response in patients with normal GFR. After five days of treatment these correlations were absent, indicating similar renal vasodilation in patients with normal and impaired renal function. Thus, multiple dose candesartan cilexitil had a favorable renal hemodynamic profile, irrespective of pretreatment renal function. Further studies are needed to establish whether this provides long-term renoprotection as well.