title: Improvements in Augmentation Index and Urinary Albumin Excretion With Benidipine in Hypertensive Patients With Chronic Kidney Disease.
abstract: Although calcium channel blockers (CCB) are expected to improve the augmentation index (AI) in CKD patients, the potential effect of benidipine on AI has been poorly studied.The present study aimed to compare the effect of benidipine and amlodipine in the treatment of CKD patients as measured through AI and urinary albumin excretion (UAE). Eligible patients with CKD were randomized to either the benidipine group or amlodipine group. Changes in UAE and AI were compared with target blood pressure level set at < 130/80 mmHg. A total of 108 patients were enrolled; 88 patients who were followed up were included in the analysis. Although no significant change in renal function was noted in either group, there was a significant improvement in AI only in the benidipine group (85.7 ± 13.3% to 81.4 ± 15.2%; P = 0.021) A subgroup analysis of 64 patients who achieved SBP < 140 mmHg at the end of follow-up (31 on amlodipine and 33 on benidipine) was carried out. Significant improvement in AI was noted only in the benidipine group (84.5 ± 13.6% to 79.5 ± 15.2%; P = 0.0138). In another subgroup of patients with UAE ≥ 300 mg/g Cr, a significant improvement in UAE in the benidipine group was found compared with the amlodipine group (-25 ± 46, 51 ± 60%, P = 0.031, respectively).These results suggest that benidipine might reduce significantly AI and might have potentially greater improvements in UAE than amlodipine in advanced CKD patients receiving RAS inhibitors.
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine.
authors.forename: Tadateru
authors.initials: T
authors.lastname: Takayama
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yoda
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Yajima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kunimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000188:drug therapy* / Q000652:urine; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D004095:Dihydropyridines / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000652:urine; D008297:Male; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy / Q000652:urine*
chemical_list: D002121:Calcium Channel Blockers; D004095:Dihydropyridines; C061004:benidipine