Bauer J H, Reams G
Am J Cardiol. 1987 Jan 23;59(2):66A-71A. doi: 10.1016/0002-9149(87)90179-2.
The renal effects of the calcium entry-blocking drugs diltiazem, nifedipine, nitrendipine, nicardipine and verapamil are reviewed. Although nifedipine may acutely increase plasma renin activity, most of the calcium entry blockers have no sustained effect on any of the components of the renin-angiotensin-aldosterone system. Although all of the calcium entry blockers effectively lower blood pressure, none adversely affects renal function: Glomerular filtration rate and effective renal plasma flow are maintained. Diltiazem may increase glomerular filtration rate via attenuation of the intrarenal effects of angiotensin II or norepinephrine. Although all of the calcium entry blockers acutely increase salt and water excretion, most of the calcium entry blockers have no clinically sustained effect on salt and water excretion; serum electrolytes, urinary sodium and potassium excretion, body fluid composition and body weight are usually unchanged. Calcium entry blockers can be expected to assume a prominent role in the treatment of hypertension because of their ability to lower blood pressure while preserving renal perfusion and function.
本文综述了钙通道阻滞剂地尔硫䓬、硝苯地平、尼群地平、尼卡地平和维拉帕米对肾脏的影响。虽然硝苯地平可能会急性增加血浆肾素活性，但大多数钙通道阻滞剂对肾素 - 血管紧张素 - 醛固酮系统的任何成分都没有持续影响。虽然所有钙通道阻滞剂都能有效降低血压，但无一对肾功能产生不利影响：肾小球滤过率和有效肾血浆流量得以维持。地尔硫䓬可能通过减弱血管紧张素 II 或去甲肾上腺素的肾内作用来增加肾小球滤过率。虽然所有钙通道阻滞剂都会急性增加盐和水的排泄，但大多数钙通道阻滞剂对盐和水的排泄没有临床持续影响；血清电解质、尿钠和钾排泄、体液组成和体重通常保持不变。由于钙通道阻滞剂能够在降低血压的同时保持肾脏灌注和功能，因此有望在高血压治疗中发挥重要作用。
