シクロスポリンで治療された腎臓移植患者におけるニートレンディピンの腎機能への影響:ランダム化試験
K H Rahn1, M Barenbrock, E Fritschka
1Department of Medicine, University of Muenster, Germany. rahn@uni-muenster.de
Lancet (London, England)
|October 30, 1999
まとめ
カルシウム対抗剤であるニートレンディピンは,シクロスポリンで治療された腎臓移植患者で重要な腎臓保護効果を示しています. この効果は,腎臓の機能に悪影響を及ぼさず,血圧を下げる作用とは無関係に発生します.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 薬理学 薬理学とは
- 移植 移植 移植
背景:
- 腎臓移植患者のサイクロスポリンの使用は,腎臓の血液動力学に悪影響を及ぼす可能性があります.
- ニトレンジピンなどのカルシウム相抗薬のこれらの効果を軽減する長期的な有効性は,依然として調査中です.
研究 の 目的:
- シクロスポリンを投与された腎臓移植患者の腎機能に対するニートレンディピンの長期的な効果を評価する.
- ニートレンディピンが抗高血圧特性とは独立して腎臓保護を提供しているか否かを判断する.
主な方法:
- 253人の腎臓移植患者が参加した24ヶ月のランダム化試験です.
- 患者は血圧 (高血圧/高血圧) によって分類され,プラセボまたはニートレンディピンを投与された.
- 腎機能 (血清クレアチニン) と血圧は毎月モニタリングされ,治療意図分析が行われました.
主要な成果:
- 血清のクレアチニン濃度は,24ヶ月後にプラセボと比較して,ニトレンジピン群では有意に低かった (148.5 vs 160.8 マイクロモール/L).
- ニトレンディピンは,血圧への影響とは関係なく,重要な腎臓保護効果 (p=0.025) を示した.
- ノルモテンシブな患者では,ニトレンジピンは血圧を低下させ,高血圧患者では,血圧はグループ間で類似したままでした.
結論:
- ニートレンディピンは,シクロスポリンを投与している腎臓移植患者の腎臓機能に安全です.
- カルシウム対抗剤であるニートレンディピンは,小さいが重要な腎臓保護効果をもたらします.
- この腎臓保護は,ニトレンジピンの抗高血圧効果に関係なく達成されます.
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