Ruilope L M, Araque A, Lahera V, Suarez C
Unidad de Hipertensión, Hospital 12 de Octubre, Madrid, Spain.
Ren Fail. 1993;15(3):359-63. doi: 10.3109/08860229309054945.
Calcium antagonists exert several characteristic effects on the kidney that potentiate their antihypertensive effect. The objective of the present study was to investigate the effectiveness of nitrendipine in the presence of different degrees of renal impairment. Two groups of hypertensive patients were included in the study. Group 1:10 patients with arterial hypertension secondary to chronic renal parenchymatous disease and adequately controlled with a diuretic and/or a beta-blocker who were switched to nitrendipine. These patients were then followed monthly for 1 year. Group 2:24 patients diagnosed as having essential hypertension who presented values of urinary albumin excretion above 30 mg/day after a minimum of 3 years of adequate blood pressure control with a diuretic and/or a beta-blocker. Patients were randomly assigned to continue with the same therapy or to switch to nitrendipine for 1 year. In both groups nitrendipine was as efficacious as standard therapy for controlling blood pressure and did not induce changes in renal hemodynamics. Nitrendipine did not modify the level of proteinuria in group 1, nor the urinary excretion of albumin in group 2. These results seem to indicate that nitrendipine can be safely used in patients with arterial hypertension and different degrees of renal function impairment.
钙拮抗剂对肾脏产生多种特性作用，这些作用增强了它们的降压效果。本研究的目的是探讨尼群地平在不同程度肾功能损害情况下的有效性。两组高血压患者纳入了该研究。第1组：10例继发于慢性肾实质疾病的动脉高血压患者，此前使用利尿剂和/或β受体阻滞剂血压控制良好，转而使用尼群地平治疗。随后对这些患者进行为期1年的每月随访。第2组：24例确诊为原发性高血压的患者，在使用利尿剂和/或β受体阻滞剂充分控制血压至少3年后，尿白蛋白排泄量超过30mg/天。患者被随机分配继续原治疗或转而使用尼群地平治疗1年。在两组中，尼群地平在控制血压方面与标准治疗同样有效，且未引起肾血流动力学改变。尼群地平未改变第1组的蛋白尿水平，也未改变第2组的尿白蛋白排泄量。这些结果似乎表明，尼群地平可安全用于患有动脉高血压和不同程度肾功能损害的患者。
