title: Dihydropyridine calcium channel blockers and renal disease.
abstract: Although blood pressure control is considered the main mechanism for preventing the progression of chronic kidney disease (CKD), angiotensin-converting enzyme inhibitors and angiotensin receptors blockers have an additional organ-protective role. The effects of calcium channel blockers (CCBs) in renal disease are not so clearly defined. CCBs have pleiotropic effects that might contribute to protection of the kidney, such as attenuating the mesangial entrapment of macromolecules, countervailing the mitogenic effect of platelet-derived growth factors and platelet-activating factors and suppressing mesangial cell proliferation. Some evidence has accumulated in recent years demonstrating that the new dihydropyridinic CCBs (such as lercanidipine or efonidipine) may affect both postglomerular and preglomerular vessels, resulting in a decreased filtration fraction and nephroprotective effect. Increasing clinical and experimental evidence supports this view and the use of CCBs in CKD hypertensive patients.
authors.affiliation: Cátedra de Riesgo Cardiovascular, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain.
authors.forename: Nicolás R
authors.initials: NR
authors.lastname: Robles
authors.affiliation: Clinica Medica, Università Milano-Bicocca, Monza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fici
authors.affiliation: Clinica Medica, Università Milano-Bicocca, Monza, Italy.|IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
mesh_terms: D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000494:pharmacology / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004095:Dihydropyridines