Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, and Nihon Universiyt Nerima Hikarigaoka Hospital, 30-1, Oyaguchi Kami-chou, Itabashi-ku, Tokyo, 173-8610, Japan.
Expert Opin Investig Drugs. 2010 Sep;19(9):1027-37. doi: 10.1517/13543784.2010.505918.
Benidipine, an L-/T-type calcium channel blocker, dilates renal efferent and afferent arterioles and reduces glomerular pressure; therefore, it may exert renoprotective effects. We conducted an open-labeled randomized trial to compare the effects of benidipine with cilnidipine in hypertensive patients with chronic kidney disease (CKD).
The patients who were already being treated with angiotensin receptor blockers (ARBs) received one of the following treatment regimens: benidipine at a dose of 2 mg/day that was increased up to a dose of 8 mg/day (benidipine group; n=118) or cilnidipine at a dose of 5 mg/day that was increased up to a dose of 20 mg/day (cilnidipine group; n=115).
After 12 months of treatment, we observed a significant and comparable reduction in the systolic and diastolic blood pressure in both groups. The urinary protein:creatinine ratio was significantly decreased in both groups after 3 months of treatment and thereafter; however, the difference between both groups was not significant after 12 months of treatment. Benidipine exerted an antiproteinuric effect to a greater extent than cilnidipine in patients with diabetes.
The addition of benidipine as well as cilnidipine reduces urinary protein excretion in hypertensive patients with CKD who are already being administered ARBs.
贝尼地平是一种 L-/T 型钙通道阻滞剂，可扩张肾传出和传入小动脉，降低肾小球压力；因此，它可能具有肾保护作用。我们进行了一项开放标签的随机试验，比较了贝尼地平和西尼地平在患有慢性肾脏病（CKD）的高血压患者中的作用。
已经接受血管紧张素受体阻滞剂（ARBs）治疗的患者接受以下治疗方案之一：贝尼地平剂量为 2 毫克/天，增至 8 毫克/天（贝尼地平组；n=118）或西尼地平剂量为 5 毫克/天，增至 20 毫克/天（西尼地平组；n=115）。
治疗 12 个月后，我们观察到两组的收缩压和舒张压均有显著且可比的降低。两组患者在治疗 3 个月后尿蛋白/肌酐比值均显著下降，此后一直如此；然而，治疗 12 个月后两组之间的差异无统计学意义。贝尼地平在糖尿病患者中的蛋白尿作用比西尼地平更明显。
在已经接受 ARBs 治疗的 CKD 高血压患者中，添加贝尼地平和西尼地平均可减少尿蛋白排泄。
