title: Use of Calcium Channel Blockers is Associated with Mortality in Patients with Chronic Kidney Disease.
abstract: OBJECTIVE
  The use of antihypertensive medicines has been shown to reduce proteinuria, morbidity, and mortality in patients with chronic kidney disease (CKD). A specific recommendation for a class of antihypertensive drugs is not available in this population, despite the pharmacodynamic differences. We have therefore analysed the association between antihypertensive medicines and survival of patients with chronic kidney disease.
  
  
  METHODS
  Out of 2687 consecutive patients undergoing kidney biopsy a cohort of 606 subjects with retrievable medical therapy was included into the analysis. Kidney function was assessed by glomerular filtration rate (GFR) estimation at the time point of kidney biopsy. Main outcome variable was death.
  
  
  RESULTS
  Overall 114 (18.7%) patients died. In univariate regression analysis the use of alpha-blockers and calcium channel antagonists, progression of disease, diabetes mellitus (DM) type 1 and 2, arterial hypertension, coronary heart disease, peripheral vascular disease, male sex and age were associated with mortality (all p<0.05). In a multivariate Cox regression model the use of calcium channel blockers (HR 1.89), age (HR 1.04), DM type 1 (HR 8.43) and DM type 2 (HR 2.17) and chronic obstructive pulmonary disease (HR 1.66) were associated with mortality (all p < 0.05).
  
  
  CONCLUSIONS
  The use of calcium channel blockers but not of other antihypertensive medicines is associated with mortality in primarily GN patients with CKD.
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.
authors.forename: Dominik G
authors.initials: DG
authors.lastname: Haider
authors.forename: Thomas
authors.initials: T
authors.lastname: Sauter
authors.forename: Gregor
authors.initials: G
authors.lastname: Lindner
authors.forename: Salome
authors.initials: S
authors.lastname: Masghati
authors.forename: Slobodan
authors.initials: S
authors.lastname: Peric
authors.forename: Alexander
authors.initials: A
authors.lastname: Friedl
authors.forename: Michael
authors.initials: M
authors.lastname: Wolzt
authors.forename: Walter H
authors.initials: WH
authors.lastname: Hörl
authors.forename: Afschin
authors.initials: A
authors.lastname: Soleiman
authors.forename: Aristomenis
authors.initials: A
authors.lastname: Exadaktylos
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuhrmann
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001706:Biopsy; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality* / Q000473:pathology; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers