Use of calcium antagonists in renal patients: therapeutic benefit or medical malpractice?
In patients with kidney disease, control of hypertension is paramount in helping to slow down the progression of both diabetic and nondiabetic nephropathy. A significant amount of data have been published that suggest blockade of the renin-angiotensin system should be considered as first-line therapy for patients with kidney disease. Meanwhile, some studies have suggested that the use of calcium channel blockers may have deleterious effects on patients with kidney disease. This manuscript reviews the renal outcomes of trials in which calcium channel blockers were included in the management of patients with and without kidney disease. The data suggest that agents that block the renin-angiotensin system are superior to calcium channel blockers in protecting against progressive kidney disease. However, there is no conclusive evidence that calcium channel blockers are injurious to the kidney, and they may be particularly beneficial in post-renal transplant patients.
Nigbor
Douglas A
DA
Division of Nephrology, Vanderbilt University Medical Center, S-3223 MCN, Nashville, TN 37232-2372, USA.
Lewis
Julia B
JB
D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000188:drug therapy; D004095:Dihydropyridines / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007674:Kidney Diseases / Q000188:drug therapy*; D016030:Kidney Transplantation; D008318:Malpractice; D012084:Renin-Angiotensin System / Q000187:drug effects
D002121:Calcium Channel Blockers; D004095:Dihydropyridines