Peng Meng, Jiang Xiong-jing, Dong Hui, Zou Yu-bao, Zhang Hui-min, Wu Hai-ying, Yang Yuejin
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China.
Curr Med Res Opin. 2015 Jan;31(1):177-82. doi: 10.1185/03007995.2014.960071. Epub 2014 Nov 26.
To investigate the renal-protective effect of lercanidipine in patients undergoing renal artery intervention.
A prospective, single-center, cohort study was conducted and patients, 30-75 years of age, with atherosclerotic renal artery stenosis were consecutively enrolled between September 2011 and October 2012. Lercanidipine (10-20 mg/day) was regularly taken after the intervention. Follow up visits were performed at 3 and 6 months after the intervention. Serum creatinine, clinical blood pressure, 24 hour ambulatory blood pressure, pulse wave velocity, and 24 hour urine protein were assessed. Adverse events were recorded.
In total, 55 patients (mean age 63.5 ± 8.9 years) were enrolled and 52 completed the study. Renal function, estimated glomerular filtration rate (eGFR) and 24 hour urine protein at 3 months after the intervention were not statistically different compared with the baseline. At 6 months after the intervention eGFR significantly increased versus baseline (78 ± 23 ml/min/1.73 m(2) vs 71 ± 21 ml/min/1.73 m(2), p = 0.021); 24 hour urine protein decreased significantly (0.02 g [IQR, 0.01-0.1] vs 0.03 g [IQR, 0.01-0.28], p = 0.042). Blood pressure control improved at 3 months and 6 months after the intervention. The need for antihypertensive drugs decreased; clinical systolic blood pressure, diastolic blood pressure and 24 hour average systolic blood pressure and diastolic blood pressure decreased. The pulse wave velocity decreased after 3 and 6 months. At the end of follow-up, none of the following adverse events occurred: death, dialysis, myocardial infarction or stroke. Mild lower extremity edema occurred in only one patient. No other side effects occurred.
This study showed that lercanidipine can improve renal function in patients undergoing renal artery intervention.
探讨乐卡地平对接受肾动脉介入治疗患者的肾脏保护作用。
进行了一项前瞻性、单中心队列研究，连续纳入2011年9月至2012年10月期间年龄在30 - 75岁的动脉粥样硬化性肾动脉狭窄患者。介入治疗后规律服用乐卡地平（10 - 20毫克/天）。在介入治疗后3个月和6个月进行随访。评估血清肌酐、临床血压、24小时动态血压、脉搏波速度和24小时尿蛋白。记录不良事件。
共纳入55例患者（平均年龄63.5±8.9岁），52例完成研究。介入治疗后3个月时，肾功能、估算肾小球滤过率（eGFR）和24小时尿蛋白与基线相比无统计学差异。介入治疗后6个月时，eGFR较基线显著升高（78±23毫升/分钟/1.73平方米对71±21毫升/分钟/1.73平方米，p = 0.021）；24小时尿蛋白显著降低（0.02克[四分位间距，0.01 - 0.1]对0.03克[四分位间距，0.01 - 0.28]，p = 0.042）。介入治疗后3个月和6个月时血压控制情况改善。降压药物需求减少；临床收缩压、舒张压以及24小时平均收缩压和舒张压均降低。3个月和6个月后脉搏波速度降低。随访结束时，未发生以下任何不良事件：死亡、透析、心肌梗死或中风。仅1例患者出现轻度下肢水肿。未发生其他副作用。
本研究表明乐卡地平可改善接受肾动脉介入治疗患者的肾功能。
