Leonetti G, Zanchetti A
Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.
J Hypertens Suppl. 1985 Dec;3(3):S535-9.
This summary report of various clinical studies by our group describes the effects on renal excretion of water and sodium of several different calcium antagonists (verapamil, gallopamil, nifedipine and felodipine) which were administered for variable periods of time (from a single administration to repeated doses over up to 10 days) to hypertensive patients. All calcium antagonists tested displayed some diuretic and natriuretic action, despite profound differences in chemical nature and in pharmacodynamic properties. On single-dose administration the renal action of calcium antagonists was prompt, appearing during the first few hours, and decaying and ending after 6 h. When repeated doses were administered over several days the effect was at a maximum during the first 2 days and then disappeared in the following days, but the negative sodium balance which developed during the first 2 days was maintained for at least 7-10 days. The natriuretic effect was not accompanied by any change in the glomerular filtration rate, but with felodipine, a natriuretic effect observed at small doses reverted to an antinatriuretic effect at higher doses, at which the glomerular filtration rate was slightly decreased.
本小组各项临床研究的总结报告描述了几种不同钙拮抗剂（维拉帕米、加洛帕米、硝苯地平和非洛地平）对高血压患者肾水排泄和钠排泄的影响，这些钙拮抗剂给药时间长短不一（从单次给药到连续给药长达10天）。尽管化学性质和药效学特性存在显著差异，但所有受试钙拮抗剂均显示出一定的利尿和排钠作用。单次给药时，钙拮抗剂的肾脏作用迅速，在最初几个小时内出现，6小时后逐渐衰减并结束。连续给药数天，效应在最初2天达到最大，随后在接下来的几天消失，但最初2天出现的负钠平衡至少维持7 - 10天。排钠效应并未伴随肾小球滤过率的任何变化，但对于非洛地平，小剂量时观察到的排钠效应在高剂量时转变为抗排钠效应，此时肾小球滤过率略有下降。
