Francischetti E A, Barroso I, da Silva A, Fagundes V G
Department of Medicine, Rio de Janeiro State University, Brazil.
J Cardiovasc Pharmacol. 1992;19 Suppl 3:S90-2.
The objective of this double-blind, placebo-controlled study was to evaluate the effects of isradipine on renal hemodynamics and function. Ten patients with mild-to-moderate hypertension were given isradipine at 2.5 mg twice daily for 3 months after 4 weeks of placebo washout. Renal studies were performed 2 h after the morning administration of treatment. The results of these evaluations indicate that isradipine as monotherapy significantly reduced the mean arterial pressure, while the effective renal plasma flow was increased (+16%) and glomerular filtration rate remained virtually unchanged (-8.7 ml/min). The filtration fraction and renal vascular resistance decreased significantly. There was a significant decrease in the absolute rate of proximal sodium reabsorption, and a significant increase in the distal reabsorption. Clearance of sodium remained unchanged. In conclusion, monotherapy with low-dose isradipine was not only effective in controlling blood pressure, but also decreased the renal vascular resistance while avoiding glomerular hyperfiltration, and exerted a protective effect on renal hemodynamics. Natriuresis also remained stable despite the blood pressure reduction.
这项双盲、安慰剂对照研究的目的是评估伊拉地平对肾血流动力学和功能的影响。10例轻至中度高血压患者在停用安慰剂4周后，给予伊拉地平2.5mg，每日2次，持续3个月。在早晨给药治疗2小时后进行肾脏研究。这些评估结果表明，伊拉地平单药治疗可显著降低平均动脉压，同时有效肾血浆流量增加（+16%），而肾小球滤过率基本保持不变（-8.7ml/min）。滤过分数和肾血管阻力显著降低。近端钠重吸收的绝对速率显著降低，而远端重吸收显著增加。钠清除率保持不变。总之，小剂量伊拉地平单药治疗不仅有效控制血压，还降低了肾血管阻力，同时避免了肾小球高滤过，对肾血流动力学发挥了保护作用。尽管血压降低，但尿钠排泄仍保持稳定。
