title: Switching to an L/N-type calcium channel blocker shows renoprotective effects in patients with chronic kidney disease: the Kyoto Cilnidipine Study.
abstract: OBJECTIVE
  This open-label, randomized controlled trial investigated the effects of cilnidipine, an L/N-type calcium channel blocker (CCB), in patients with chronic kidney disease (CKD).
  
  
  METHODS
  Sixty patients with CKD and well-controlled hypertension being treated with a renin-  angiotensin system (RAS) inhibitor and an L-type CCB (L-CCB) were randomly assigned either to switch from the L-CCB to cilnidipine after a 4-week observation period or to continue with L-CCB treatment. Blood pressure, heart rate and renal function were monitored for 12 months. Data were available  for analysis from 50 patients: 24 from the cilnidipine group and 26 from the L-CCB group.
  
  
  RESULTS
  Blood pressure was well controlled in both groups. After 12 months, proteinuria and heart rate were significantly decreased in the cilnidipine group, but proteinuria increased and heart rate  remained unchanged in the L-CCB group. There was a significant positive correlation between the percentage changes in proteinuria and heart rate.
  
  
  CONCLUSIONS
  Cilnidipine has antihypertensive effects equivalent to those of L-CCBs. In patients with CKD, proteinuria can be decreased by switching  from an L-CCB to cilnidipine, thereby improving renal function.
authors.affiliation: Department of Medicine, Division of Hypertension and Nephrology, Omihachiman Community Medical Centre, 1379 Tsuchida-cho, Omihachiman City, Shiga 523-0082, Japan. tsuguhatta@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Hatta
authors.forename: K
authors.initials: K
authors.lastname: Takeda
authors.forename: Y
authors.initials: Y
authors.lastname: Shiotsu
authors.forename: C
authors.initials: C
authors.lastname: Sugishita
authors.forename: T
authors.initials: T
authors.lastname: Adachi
authors.forename: T
authors.initials: T
authors.lastname: Kimura
authors.forename: K
authors.initials: K
authors.lastname: Sonomura
authors.forename: T
authors.initials: T
authors.lastname: Kusaba
authors.forename: N
authors.initials: N
authors.lastname: Kishimioto
authors.forename: H
authors.initials: H
authors.lastname: Narumiya
authors.forename: S
authors.initials: S
authors.lastname: Tanda
authors.forename: K
authors.initials: K
authors.lastname: Tamagaki
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: H
authors.initials: H
authors.lastname: Kameyama
authors.forename: H
authors.initials: H
authors.lastname: Kido
authors.forename: S
authors.initials: S
authors.lastname: Harada
authors.forename: Y
authors.initials: Y
authors.lastname: Bito
authors.forename: J
authors.initials: J
authors.lastname: Moriguchi
authors.forename: S
authors.initials: S
authors.lastname: Morimoto
authors.forename: M
authors.initials: M
authors.lastname: Okigaki
authors.forename: H
authors.initials: H
authors.lastname: Itoh
authors.forename: Y
authors.initials: Y
authors.lastname: Mori
authors.forename: T
authors.initials: T
authors.lastname: Nakata
authors.forename: K
authors.initials: K
authors.lastname: Maki
authors.forename: S
authors.initials: S
authors.lastname: Sasaki
authors.forename: K
authors.initials: K
authors.lastname: Sawada
authors.forename: H
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects; D020746:Calcium Channels, L-Type / Q000502:physiology; D020864:Calcium Channels, N-Type / Q000502:physiology; D003404:Creatinine / Q000097:blood; D004095:Dihydropyridines / Q000008:administration & dosage* / Q000009:adverse effects; D004232:Diuretics / Q000627:therapeutic use; D057915:Drug Substitution; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000188:drug therapy* / Q000652:urine
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D020746:Calcium Channels, L-Type; D020864:Calcium Channels, N-Type; D004095:Dihydropyridines; D004232:Diuretics; C065927:cilnidipine; D003404:Creatinine