Effects of calcium antagonists in hypertensive patients with renal dysfunction: a prospective, randomized, parallel trial comparing benidipine and nifedipine.
BACKGROUND
Although calcium antagonists, derived from dihydropyridine (DHP), are important agents in achieving control in a majority of patients with high blood pressure and renal disease, there are no comparative data regarding their inhibitory effects on the progression of renal dysfunction in Japan.


METHODS
Benidipine and nifedipine retard both calcium antagonists derived from DHP and were compared in terms of their inhibitory effect on the progression of renal dysfunction in hypertensive patients. The primary end-points were defined as 1.5 times the serum creatinine value at baseline, progression to end-stage renal failure (ESRF) necessitating dialysis or renal transplantation, and death.


RESULTS
During the study period, a significant decline in blood pressure was observed in the two groups, with no significant difference between them. The worsening of nephropathy was significantly inhibited in the benidipine group as compared with the nifedipine retard group (log-rank test: P = 0.014, Wilcoxon's test: P = 0.022). Among the subjects who reached a primary end-point, one (33%) in the benidipine group and five (50%) in the nifedipine retard group were placed on haemodialysis within 1 year.


CONCLUSIONS
It appears that benidipine inhibits the progression of hypertensive renal diseases more effectively than nifedipine retard.
Inoue
Sanae
S
Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Tomino
Yasuhiko
Y
D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D006978:Hypertension, Renovascular / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D011446:Prospective Studies
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; C061004:benidipine; D009543:Nifedipine