Korean J Nephrol.  2010 May;29(3):322-328.

Effect of Efonidipine on Proteinuria in Patients with Chronic Kidney Disease Receiving RAS Blockade

• Wi JK
• Jeong KW
• Lee TW
• Lee SH
• Moon JY
• Cha DR
• Ha SK
• Kim SB
• Kwak IS
• Ihm CG

Abstract

PURPOSE
Efonidipine, which inhibits both T- and L-type calcium channels, has been shown to be effective in reducing proteinuria and preserve renal function. This study was conducted to compare the effects of efonidipine versus amlodipine on the management of hypertension and proteinuria in patients with chronic kidney disease (CKD) receiving ACE inhibitors or ARB.
METHODS
This study included 41 CKD patients who were at stages 2-4 and had a urine spot protein/ creatinine ratio of >0.5. Patients were administered amlodipine (5 mg/day) and efonidipine (40 mg/ day) for 3 months in a cross-over design. Blood pressure and spot urine protein/creatinine ratio were compared before and after the cross-over treatment.
RESULTS
There were 24 male patients and 17 female patients. The mean age of the patients was 55.9+/-12.9 years. When the patients' medication was changed to eponidifine, we obtained the following results. First, there were no significant changes in blood pressure and serum creatinine. Second, the urine spot protein/creatinine ratio was significantly decreased (before the cross-over, 2.9+/-2.6; after the cross-over, 2.3+/-1.9 g/g; p=0.02). Finally, the reduction rate of proteinuria was significantly higher in patients with CKD at stages 2-3 than in those with CKD at stage 4 after the cross-over (stage 2, - 26.1%; stage 3, -17%; stage 4, +12.8%; p=0.03).
CONCLUSION
It is concluded that efonidipine may significantly decrease proteinuria compared with amlodipine in CKD patients receiving ACE inhibitors or ARB. Further double-blind clinical trials with a larger sample size are needed to confirm our results.

Keyword

Calcium channel blocker; Efonidipine; Amlodipine; Proteinuria

MeSH Terms

Amlodipine
Angiotensin-Converting Enzyme Inhibitors
Blood Pressure
Calcium Channels, L-Type
Creatinine
Cross-Over Studies
Dihydropyridines
Female
Humans
Hypertension
Male
Nitrophenols
Organophosphorus Compounds
Proteinuria
Renal Insufficiency, Chronic
Sample Size
Amlodipine
Angiotensin-Converting Enzyme Inhibitors
Calcium Channels, L-Type
Creatinine
Dihydropyridines
Nitrophenols
Organophosphorus Compounds