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慢性肾脏病患者的钙通道阻滞剂。

Calcium channel blocker in patients with chronic kidney disease.

机构信息

Department of Nephrology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.

出版信息

Clin Exp Nephrol. 2022 Mar;26(3):207-215. doi: 10.1007/s10157-021-02153-1. Epub 2021 Nov 8.

Abstract

BACKGROUND

Chronic kidney disease (CKD) is involved in a progressive deterioration in renal function over the years and is now a global public health problem. Currently, reducing the number of patients progressing to end-stage renal failure is urgently necessary. Hypertension and CKD interact with each other, and good control of blood pressure (BP) can improve CKD patients' prognosis. With the current global trend for more strict BP control, the importance of BP management and the need for medication to achieve this strict goal are increasing. Calcium channel blockers (CCBs), which target voltage-dependent calcium channels, are frequently used in combination with renin-angiotensin-aldosterone system inhibitors for CKD patients because of their strong BP-lowering properties and relatively few adverse side effects. Calcium channels have several subtypes, including L, N, T, P/Q, and R, and three types of CCBs, L-type CCBs, L-/T-type CCBs, and L-/N-type CCBs, that are available. Nowadays, the new functions and effects of the CCBs are being elucidated.

CONCLUSION

We should use different types of CCBs properly depending on their pharmacological effects, such as the strength of antihypertensive effects and the organ protection effects, taking into account the pathophysiology of the patients. In this article, the role and the use of CCBs in CKD patients are reviewed.

摘要

背景

慢性肾脏病(CKD)是一种随着时间推移肾功能逐渐恶化的疾病,现已成为全球公共卫生问题。目前,迫切需要减少进展为终末期肾衰竭的患者数量。高血压和 CKD 相互作用,良好的血压(BP)控制可以改善 CKD 患者的预后。随着当前全球血压控制更为严格的趋势,BP 管理的重要性以及实现这一严格目标所需的药物治疗日益增加。钙通道阻滞剂(CCB)作用于电压依赖性钙通道,由于其强大的降压特性和相对较少的不良反应,常与肾素-血管紧张素-醛固酮系统抑制剂联合用于 CKD 患者。钙通道有几种亚型,包括 L、N、T、P/Q 和 R,有三种类型的 CCB,即 L 型 CCB、L-/T 型 CCB 和 L-/N 型 CCB。如今,正在阐明 CCB 的新功能和新作用。

结论

我们应根据 CCB 的药理作用,如降压作用和器官保护作用的强度,考虑患者的病理生理学,合理使用不同类型的 CCB。本文综述了 CCB 在 CKD 患者中的作用和用途。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98c3/8847284/daa3e0154a37/10157_2021_2153_Fig1_HTML.jpg

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