Effects of the N/L‐Type Calcium Channel Blocker Cilnidipine on Nephropathy and Uric Acid Metabolism in Hypertensive Patients With Chronic Kidney Disease (J‐CIRCLE Study)

This study assessed the urinary albumin/creatinine ratio (ACR) and uric acid metabolism in 70 hypertensive patients with chronic kidney disease in whom urinary ACR had remained ≥30 mg/g under the treatment of the L‐type calcium channel blocker amlodipine. Three months after switching to the N/L‐type...

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Bibliographic Details
Published in:The journal of clinical hypertension (Greenwich, Conn.) Conn.), 2014-10, Vol.16 (10), p.746-753
Main Authors: Uchida, Shunya, Takahashi, Masato, Sugawara, Masahiro, Saito, Tomoaki, Nakai, Kazuhiko, Fujita, Masami, Mochizuki, Koichi, Shin, Isu, Morita, Takashi, Hikita, Tomoyuki, Itakura, Hironao, Takahashi, Yuko, Mizuno, Shigeki, Ohno, Yasumi, Ito, Kageki, Ito, Takafumi, Soma, Masayoshi
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Albuminuria - blood
Albuminuria - drug therapy
Amlodipine - adverse effects
Amlodipine - therapeutic use
Blood Pressure - drug effects
Calcium Channel Blockers - adverse effects
Calcium Channel Blockers - therapeutic use
Creatinine - blood
Cross-Over Studies
Diabetic Nephropathies - blood
Diabetic Nephropathies - drug therapy
Dihydropyridines - adverse effects
Dihydropyridines - therapeutic use
Dose-Response Relationship, Drug
Drug Substitution
Female
Humans
Hypertension, Renal - blood
Hypertension, Renal - drug therapy
Japan
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - drug therapy
Male
Middle Aged
Nephrosclerosis - blood
Nephrosclerosis - drug therapy
Original Paper
Original Papers
Uric Acid - blood
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Summary:This study assessed the urinary albumin/creatinine ratio (ACR) and uric acid metabolism in 70 hypertensive patients with chronic kidney disease in whom urinary ACR had remained ≥30 mg/g under the treatment of the L‐type calcium channel blocker amlodipine. Three months after switching to the N/L‐type calcium channel blocker cilnidipine, blood pressure (BP) did not change; however, urinary ACR significantly decreased with cilnidipine. Serum uric acid levels showed no significant change. In cases where uric acid production had been high (urinary uric acid/creatinine ratio ≥0.5), the urinary uric acid/creatinine ratio decreased significantly after cilnidipine treatment, suggesting that cilnidipine can suppress excessive uric acid formation. These results suggest that switching from amlodipine to cilnidipine results in a significant reduction in urinary ACR as well as significant reduction in uric acid production. Thus, cilnidipine is more useful than amlodipine in improving albuminuria and uric acid metabolism in hypertensive patients with chronic kidney disease.
ISSN:1524-6175
1751-7176
1751-7176
DOI:10.1111/jch.12412