Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs

Aim. Most calcium antagonists do not seem to reduce microalbuminuria or proteinuria. We have tried to assess the antiproteinuric effect of a calcium channel blocker, lercanidipine, in patients previously treated with ACE inhibitors or angiotensin receptor blockers. Design and methods. The study incl...

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Main Authors: N. R. Robles, B. Romero, E. Garcia de Vinuesa, E. Sánchez-Casado, J. J. Cubero
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 2011-06-01
Series:Кардиоваскулярная терапия и профилактика
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Online Access:https://cardiovascular.elpub.ru/jour/article/view/1838
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author N. R. Robles
B. Romero
E. Garcia de Vinuesa
E. Sánchez-Casado
J. J. Cubero
author_facet N. R. Robles
B. Romero
E. Garcia de Vinuesa
E. Sánchez-Casado
J. J. Cubero
author_sort N. R. Robles
collection DOAJ
description Aim. Most calcium antagonists do not seem to reduce microalbuminuria or proteinuria. We have tried to assess the antiproteinuric effect of a calcium channel blocker, lercanidipine, in patients previously treated with ACE inhibitors or angiotensin receptor blockers. Design and methods. The study included 68 proteinuric (>500 mg/day) patients (age 63,1±12,9 years, 69,1 % males and 30,9 % females). All patients were receiving ACE inhibitors (51,4 %) or angiotensin II receptor blockers (48,6 %) therapy but had higher blood pressure (BP) than recommended for proteinuric patients (<130/80 mm Hg). Patients were clinically evaluated one, three, and six months after starting treatment with lercanidipine (20 mg/day). Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to treatment. Creatinine clearance was measured using 24 h urine collection. Results. BP significantly decreased from 152±15/86±11 mm Hg to 135±12/77±10 mm Hg at six months of follow-up (p<0,001). After six months of treatment, the percentage of normalized patients (BP <130/80 mm Hg) was 42,5 %, and the proportion of patients whose BP was below 140/90 mm Hg was 58,8 %. Plasmatic creatinine did not change nor did creatinine clearance. Plasmatic cholesterol also decreased from 210±48 to 192±34 mg/dL (p<0,001), as did plasma triglycerides (from 151±77 to 134±72 mg/dL, p=0,022). Basal proteinuria was 1,63±1,34 g/day; it was significantly (p<0,001) reduced by 23 % at the first month, 37 % at three months, and 33 % at the last visit.Conclusion. Lercanidipine at 20 mg dose, associated with renin-angiotensin axis-blocking drugs, showed a high antihypertensive and antiproteinuric effect. This antiproteinuric effect seems to be dose-dependent as compared with previous reports and proportionally higher than blood pressure reduction.
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institution Kabale University
issn 1728-8800
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language Russian
publishDate 2011-06-01
publisher «SILICEA-POLIGRAF» LLC
record_format Article
series Кардиоваскулярная терапия и профилактика
spelling doaj-art-7d64aeaef8d148ea9a9ffcee8f2489832025-08-20T03:57:09Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252011-06-01103838810.15829/1728-8800-2011-3-83-881553Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugsN. R. Robles0B. Romero1E. Garcia de Vinuesa2E. Sánchez-Casado3J. J. Cubero4Cátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta CristinaCátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta CristinaCátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta CristinaCátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta CristinaCátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta CristinaAim. Most calcium antagonists do not seem to reduce microalbuminuria or proteinuria. We have tried to assess the antiproteinuric effect of a calcium channel blocker, lercanidipine, in patients previously treated with ACE inhibitors or angiotensin receptor blockers. Design and methods. The study included 68 proteinuric (>500 mg/day) patients (age 63,1±12,9 years, 69,1 % males and 30,9 % females). All patients were receiving ACE inhibitors (51,4 %) or angiotensin II receptor blockers (48,6 %) therapy but had higher blood pressure (BP) than recommended for proteinuric patients (<130/80 mm Hg). Patients were clinically evaluated one, three, and six months after starting treatment with lercanidipine (20 mg/day). Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to treatment. Creatinine clearance was measured using 24 h urine collection. Results. BP significantly decreased from 152±15/86±11 mm Hg to 135±12/77±10 mm Hg at six months of follow-up (p<0,001). After six months of treatment, the percentage of normalized patients (BP <130/80 mm Hg) was 42,5 %, and the proportion of patients whose BP was below 140/90 mm Hg was 58,8 %. Plasmatic creatinine did not change nor did creatinine clearance. Plasmatic cholesterol also decreased from 210±48 to 192±34 mg/dL (p<0,001), as did plasma triglycerides (from 151±77 to 134±72 mg/dL, p=0,022). Basal proteinuria was 1,63±1,34 g/day; it was significantly (p<0,001) reduced by 23 % at the first month, 37 % at three months, and 33 % at the last visit.Conclusion. Lercanidipine at 20 mg dose, associated with renin-angiotensin axis-blocking drugs, showed a high antihypertensive and antiproteinuric effect. This antiproteinuric effect seems to be dose-dependent as compared with previous reports and proportionally higher than blood pressure reduction.https://cardiovascular.elpub.ru/jour/article/view/1838lercanidipineproteinuriahypertension
spellingShingle N. R. Robles
B. Romero
E. Garcia de Vinuesa
E. Sánchez-Casado
J. J. Cubero
Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs
Кардиоваскулярная терапия и профилактика
lercanidipine
proteinuria
hypertension
title Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs
title_full Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs
title_fullStr Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs
title_full_unstemmed Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs
title_short Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs
title_sort treatment of proteinuria with lercanidipine associated with reninangiotensin axis blocking drugs
topic lercanidipine
proteinuria
hypertension
url https://cardiovascular.elpub.ru/jour/article/view/1838
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AT egarciadevinuesa treatmentofproteinuriawithlercanidipineassociatedwithreninangiotensinaxisblockingdrugs
AT esanchezcasado treatmentofproteinuriawithlercanidipineassociatedwithreninangiotensinaxisblockingdrugs
AT jjcubero treatmentofproteinuriawithlercanidipineassociatedwithreninangiotensinaxisblockingdrugs