Srivathsan Mayakalyani, Vardhan Vikram, Naseem Azra, Patil Sayali, Rai Vivek, Langade Deepakkumar G
Pharmacology, DY Patil University School of Medicine, Navi Mumbai, IND.
Anaesthesia, DY Patil University School of Medicine, Navi Mumbai, IND.
Cureus. 2022 Aug 10;14(8):e27847. doi: 10.7759/cureus.27847. eCollection 2022 Aug.
Nearly 65%-95% of chronic kidney disease (CKD) patients have hypertension. Calcium-channel blockers are the first-line drugs for the treatment of hypertension, including hypertension with diabetes. This study aims to estimate the effect of an L-type calcium channel blocker (CCB), cilnidipine, on the renal function of hypertensive patients. Randomized control trials were selected from PubMed, Embase, Google Scholar, China National Knowledge Infrastructure (CNKI), Science Direct, Elton B. Stephens Company (EBSCO), Springer, Ovid, Cochrane Library, Medline, VIP, and Wanfang databases (from the date of databases' establishment till January 2022). Data were independently evaluated following the Cochrane risk-of-bias tool. The changes in serum creatinine (SCr), urinary protein excretion (UPE), urinary protein/creatinine ratio (UPCR), and estimated glomerular filtration rate (eGFR) before and after treatment, in percentages, were extracted for the meta-analysis. The mean difference (MD) and a CI of 95% were determined using RevMan 5.3 software. A total of 11 studies were analyzed. The standardized mean difference (SMD) between cilnidipine and L-type CCBs was -0.022, suggesting a reduced SCr with cilnidipine. For UPCR, the SMD value is 1.28. Although cilnidipine reduced UPCR in all four studies, the L-type CCBs reported a slight increase in UPCR. For eGFR, the SMD value was found to be 0.693. Cilnidipine had a more favorable effect on eGFR when compared to the L-type CCBs. While cilnidipine had similar effects on SCr to that of L-type CCBs, cilnidipine showed greater improvement in UPCR, UPE, and eGFR values.
近65%-95%的慢性肾脏病（CKD）患者患有高血压。钙通道阻滞剂是治疗高血压的一线药物，包括糖尿病伴高血压。本研究旨在评估L型钙通道阻滞剂西尼地平对高血压患者肾功能的影响。从PubMed、Embase、谷歌学术、中国知网（CNKI）、科学Direct、EBSCO、施普林格、Ovid、考克兰图书馆、医学在线数据库（Medline）、维普资讯（VIP）和万方数据库中选取随机对照试验（从数据库建立之日至2022年1月）。根据考克兰偏倚风险工具对数据进行独立评估。提取治疗前后血清肌酐（SCr）、尿蛋白排泄量（UPE）、尿蛋白/肌酐比值（UPCR）和估算肾小球滤过率（eGFR）的变化百分比，用于荟萃分析。使用RevMan 5.3软件确定平均差（MD）和95%置信区间（CI）。共分析了11项研究。西尼地平与L型钙通道阻滞剂之间的标准化平均差（SMD）为-0.022，表明西尼地平可降低SCr。对于UPCR，SMD值为1.28。尽管在所有四项研究中西尼地平均降低了UPCR，但L型钙通道阻滞剂报告UPCR略有升高。对于eGFR，发现SMD值为0.693。与L型钙通道阻滞剂相比，西尼地平对eGFR的影响更有利。虽然西尼地平对SCr的影响与L型钙通道阻滞剂相似，但西尼地平在UPCR、UPE和eGFR值方面显示出更大的改善。
