The effect of nifedipine GITS on renal function in hypertensive patients with renal insufficiency.
Twelve hypertensive patients with moderately severe renal dysfunction were entered into a protocol to assess the blood pressure and renal effects of the sustained release calcium antagonist, nifedipine GITS (30-180 mg/d given once a day) administered for 5 weeks. Nifedipine GITS monotherapy effectively lowered blood pressure in 50% of the patients. Glomerular filtration rate and effective renal plasma flow were increased 18% and 20%, respectively. The filtration fraction and urinary protein excretion remained unchanged. Changes that were observed in renal function were independent of the blood pressure responses of the patients; there was no correlation between the systemic and renal effect of nifedipine GITS monotherapy. Patients who had a poor systemic blood pressure response exhibited an increase in glomerular filtration rate (+11%) but had a decrease in effective renal plasma flow (-6%); patients who achieved a goal blood pressure response showed increases in both glomerular filtration rate (+35%) and effective renal plasma flow (+40%). These results show that nifedipine GITS monotherapy has the potential to improve renal function abnormalities that are encountered in hypertensive patients with renal disease; the improvement in renal function may be independent of their effect on systemic blood pressure.
Reams
G
G
Department of Medicine, University of Missouri, Columbia 65212.
Lau
A
A
Knaus
V
V
Bauer
J H
JH
D001794:Blood Pressure / Q000187:drug effects*; D003692:Delayed-Action Preparations; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008657:Metabolic Clearance Rate; D009543:Nifedipine / Q000008:administration & dosage / Q000494:pharmacology*; D012039:Regional Blood Flow
D003692:Delayed-Action Preparations; D009543:Nifedipine