title: Effects of efonidipine, an L- and T-type calcium channel blocker, on the renin-angiotensin-aldosterone system in chronic hemodialysis patients.
abstract: Components of the renin-angiotensin-aldosterone system such as angiotensin II and aldosterone are believed to contribute to the development and progression of cardiovascular tissue and organ injuries. We compared the effects of two calcium channel blockers, efonidipine and amlodipine, on the renin-angiotensin-aldosterone system in patients with end-stage renal diseases on maintenance hemodialysis. Twenty hypertensive patients on chronic hemodialysis were given efonidipine 20-60 mg twice daily and amlodipine 2.5-7.5 mg once daily for 12 weeks each in a random crossover manner. The average blood pressure was comparable between the efonidipine and amlodipine periods (151 + or - 15/77 + or - 8 versus 153 + or - 15/76 + or - 8 mmHg). The pulse rate did not change significantly during the administration periods. Although the plasma renin activity and plasma angiotensin II were not significantly different between the efonidipine and amlodipine periods, plasma aldosterone was significantly lower in the efonidipine period than in the amlodipine period (123 + or - 118 versus 146 + or - 150 pg/mL, P = 0.027). The findings suggest that efonidipine reduces plasma aldosterone levels in patients on maintenance hemodialysis, and this seems to be an additional benefit to the cardiovascular protection by antihypertensive therapy with efonidipine in patients with end-stage renal disease.
authors.affiliation: Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Nakano
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishimitsu
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Inada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okamura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ohba
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsuoka
mesh_terms: D000368:Aged; D000450:Aldosterone / Q000097:blood; D017311:Amlodipine / Q000494:pharmacology; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D020746:Calcium Channels, L-Type / Q000187:drug effects; D020747:Calcium Channels, T-Type / Q000187:drug effects; D018592:Cross-Over Studies; D004095:Dihydropyridines / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009596:Nitrophenols / Q000494:pharmacology*; D009943:Organophosphorus Compounds / Q000494:pharmacology; D006435:Renal Dialysis; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology
chemical_list: D002121:Calcium Channel Blockers; D020746:Calcium Channels, L-Type; D020747:Calcium Channels, T-Type; D004095:Dihydropyridines; D009596:Nitrophenols; D009943:Organophosphorus Compounds; D017311:Amlodipine; C066425:efonidipine; D000450:Aldosterone