Effect of a calcium-entry blocker, nicardipine, on intrarenal hemodynamics in essential hypertension.
The effects of a calcium-entry blocker, nicardipine, on intrarenal hemodynamics were studied in essential hypertension. A 4-week study was performed in eight patients with essential hypertension who were given a regular sodium diet in the first and third weeks, and a sodium-restricted diet in the second and fourth weeks. Nicardipine, 60 mg/d, was administered in the third and fourth weeks. The urinary sodium excretion rate (UNaV) was plotted on the y-axis against the mean arterial pressure (MAP) on the x-axis before and after the administration of nicardipine. Assuming the difference between MAP and the x-intercept of this renal function curve represents the effective filtration pressure across the glomerular capillaries, the intrarenal hemodynamics such as afferent arteriolar resistance (RA) and efferent arteriolar resistances (RE), glomerular pressure (PG), and gross filtration coefficient (KFG) were calculated. Although the MAP on regular salt diet was lowered from 125 +/- 3 to 109 +/- 2 mm Hg by nicardipine, neither the renal blood flow rate (RBF) (670 +/- 40 mL/min) nor the glomerular filtration rate (GFR) (79 +/- 2 mL/min) was altered. The RA was estimated to be reduced from 9,300 +/- 900 to 7,400 +/- 700 dyne.s.cm-5 (P less than 0.01), while no changes were noted in RE (4,900 +/- 400 dyne.s.cm-5), PG (50 +/- 1 mm Hg), or KFG (0.180 +/- 0.041 [mL/s]/mm Hg). Essential hypertension has been characterized by a prominent increase in RA, resulting in maintenance of normal PG. This Ca-entry blocker worked to normalize intrarenal hemodynamics in essential hypertension by dilating afferent arterioles alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Kimura
G
G
Department of Medicine, National Cardiovascular Center, Osaka, Japan.
Deguchi
F
F
Kojima
S
S
Ashida
T
T
Yoshimi
H
H
Abe
H
H
Kawano
Y
Y
Yoshida
K
K
Kawamura
M
M
Imanishi
M
M
D004039:Diet, Sodium-Restricted; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000188:drug therapy*; D007678:Kidney Glomerulus / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects; D009529:Nicardipine / Q000627:therapeutic use*; D012079:Renal Circulation / Q000187:drug effects*; D012982:Sodium, Dietary / Q000008:administration & dosage
D012982:Sodium, Dietary; D009529:Nicardipine