Protective effects of efonidipine, a T- and L-type calcium channel blocker, on renal function and arterial stiffness in type 2 diabetic patients with hypertension and nephropathy.
OBJECTIVE
The three types of calcium channel blocker (CCB), L-, T- and N-type, possess heterogeneous actions on endothelial function and renal microvascular function. In the present study, we evaluated the effects of two CCBs, efonidipine and amlodipine, on renal function and arterial stiffness.


METHODS
Forty type 2 diabetic patients with hypertension and nephropathy receiving angiotensin receptor II blockers were enrolled and randomly divided into two groups: the efonidipine group was administered efonidipine hydrochloride ethanolate 40 mg/day and the amlodipine group was admin-istered amlodipine besilate 5 mg/day for 12 months. Arterial stiffness was evaluated by the cardio-ankle vascular index (CAVI).


RESULTS
Changes in blood pressure during the study were almost the same in the two groups. Sig-nificant increases in serum creatinine and urinary albumin and a significant decrease in the esti-mated glomerular filtration rate were observed in the amlodipine group, but not in the efonidipine group. On the other hand, significant decreases in plasma aldosterone, urinary 8-hydroxy-2'-deoxy-guanosine and CAVI were observed after 12 months in the efonidipine group, but not in the amlo-dipine group.


CONCLUSIONS
These results suggest that efonidipine, which is both a T-type and L-type calcium chan-nel blocker, has more favorable effects on renal function, oxidative stress and arterial stiffness than amlodipine, an L-type calcium channel blocker.
Sasaki
Hidehisa
H
Departments of Pharmacy, Sakura Medical Center, School of Medicine, Toho University, Japan.
Saiki
Atsuhito
A
Endo
Kei
K
Ban
Noriko
N
Yamaguchi
Takashi
T
Kawana
Hidetoshi
H
Nagayama
Daizi
D
Ohhira
Masahiro
M
Oyama
Tomokazu
T
Miyashita
Yoh
Y
Shirai
Kohji
K
D000080242:8-Hydroxy-2'-Deoxyguanosine; D000368:Aged; D000450:Aldosterone / Q000097:blood; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use; D001158:Arteries / Q000187:drug effects* / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D020746:Calcium Channels, L-Type / Q000187:drug effects*; D020747:Calcium Channels, T-Type / Q000187:drug effects*; D003849:Deoxyguanosine / Q000031:analogs & derivatives / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004095:Dihydropyridines / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009596:Nitrophenols / Q000494:pharmacology / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000494:pharmacology / Q000627:therapeutic use
D000080242:8-Hydroxy-2'-Deoxyguanosine; D000450:Aldosterone; D017311:Amlodipine; D002121:Calcium Channel Blockers; D020746:Calcium Channels, L-Type; D020747:Calcium Channels, T-Type; D003849:Deoxyguanosine; D004095:Dihydropyridines; D006442:Glycated Hemoglobin; D008055:Lipids; D009596:Nitrophenols; D009943:Organophosphorus Compounds; C066425:efonidipine