Chellingsworth M, Kendall M J
Department of Therapeutics and Clinical Pharmacology, Medical School, University of Birmingham, UK.
J Hum Hypertens. 1987 Jun;1(1):3-8.
Calcium antagonists are frequently used to treat patients with hypertension or ischaemic heart disease. These patients often have renal impairment, so the effects of calcium antagonists on the kidney are important. The effects of calcium antagonists on renal haemodynamics are variable and depend on the state of the patient or animal and the dose of calcium antagonist used. Calcium antagonists cause natriuresis and diuresis by a mechanism which is not fully understood, but which is probably not directly due to the effects of calcium antagonists on renal haemodynamics. The diuretic effect may be useful in limiting the oedema which would otherwise be induced by vasodilator therapy. The effects of calcium antagonists on peripheral renin activity are unpredictable: renin release may be affected directly, as well as via haemodynamic effects. The pharmacokinetics of calcium antagonists are little changed in renal failure, since these drugs are metabolised in the liver. Calcium antagonists appear to be safe and useful treatments for patients with hypertension or ischaemic heart disease and co-existing renal impairment.
钙拮抗剂常用于治疗高血压或缺血性心脏病患者。这些患者常有肾功能损害，因此钙拮抗剂对肾脏的影响很重要。钙拮抗剂对肾血流动力学的影响是可变的，取决于患者或动物的状态以及所用钙拮抗剂的剂量。钙拮抗剂通过一种尚未完全了解的机制引起利钠和利尿，但这可能并非直接归因于钙拮抗剂对肾血流动力学的影响。利尿作用可能有助于限制血管扩张剂治疗可能引起的水肿。钙拮抗剂对外周肾素活性的影响不可预测：肾素释放可能直接受到影响，也可能通过血流动力学效应受到影响。由于这些药物在肝脏中代谢，肾衰竭时钙拮抗剂的药代动力学变化不大。钙拮抗剂似乎是治疗高血压或缺血性心脏病合并肾功能损害患者的安全有效的药物。
