Odar-Cederlöf I
Acta Pharmacol Toxicol (Copenh). 1986;58 Suppl 2:81-9. doi: 10.1111/j.1600-0773.1986.tb02524.x.
Since calcium channel blocking agents were introduced into the treatment of hypertension their influence on renal function has become an important issue. In animal experiments calcium channel blocking agents have been shown to increase renal blood flow and glomerular filtration rate and to augment urine flow and electrolyte excretion. In human acute studies the administration of calcium channel blocking agents have elicited similar renal hemodynamic and diuretic effects. Clinical studies on the renal effects of long-term treatment are however still lacking. Studies on the effect on renin release have given divergent results. In acute experiments renin release is increased by calcium channel blocking agents. In long-term treatment, however, no change in peripheral plasma levels of renin has been demonstrated. The influence of decreased renal function on the pharmacokinetics of calcium channel blocking agents has been studied in patients with renal disease. For verapamil the volume of distribution is smaller in uremic patients than in normals and both metabolic and renal clearances are decreased. For nifedipine, on the other hand, similar plasma levels, plasma half life and total plasma clearance are found in uremic patients and normal subjects.
自从钙通道阻滞剂被用于治疗高血压以来，它们对肾功能的影响已成为一个重要问题。在动物实验中，钙通道阻滞剂已被证明可增加肾血流量和肾小球滤过率，并增加尿量和电解质排泄。在人体急性研究中，钙通道阻滞剂的给药也引发了类似的肾血流动力学和利尿作用。然而，关于长期治疗对肾脏影响的临床研究仍然缺乏。关于对肾素释放影响的研究结果不一。在急性实验中，钙通道阻滞剂会增加肾素释放。然而，在长期治疗中，外周血浆肾素水平并未显示出变化。肾功能下降对钙通道阻滞剂药代动力学的影响已在肾病患者中进行了研究。对于维拉帕米，尿毒症患者的分布容积比正常人小，代谢清除率和肾清除率均降低。另一方面，对于硝苯地平，在尿毒症患者和正常受试者中发现了相似的血浆水平、血浆半衰期和总血浆清除率。
