Pearce C J, Wallin J D
Section of Nephrology, Louisiana State University School of Medicine, New Orleans 70112, USA.
New Horiz. 1996 Feb;4(1):123-8.
Calcium antagonists have evolved as an important class of cardiovascular therapeutic agents. Usefulness in treating hypertension, angina pectoris, and cardiac arrhythmias has been established. Investigations show that calcium antagonists have a role in altering renal functions. They are natriuretic and may benefit salt-sensitive hypertensives. They have been shown to block vasoconstriction of the afferent arteriole in the presence of constrictors such as endothelin, thromboxane, norepinephrine, and angiotensin II. These vasoconstrictors may be mediators of nephrotoxins such as radiocontrast agents, and cyclosporine A. Actions of calcium antagonists which are being investigated for potential benefit in ameliorating chronic renal disease include: preventing glomerular hypertrophy, blocking angiotensin II-mediated macromolecule entry into mesangial cells and cytokine release, free-radical scavenger activity, and decreasing calcium deposition within the kidney. Slowing the progression of renal disease with the calcium antagonists has been demonstrated in both short- and long-term trials. Further studies are currently underway.
钙拮抗剂已发展成为一类重要的心血管治疗药物。其在治疗高血压、心绞痛和心律失常方面的有效性已得到证实。研究表明，钙拮抗剂在改变肾功能方面发挥作用。它们具有利钠作用，可能对盐敏感性高血压患者有益。研究显示，在存在内皮素、血栓素、去甲肾上腺素和血管紧张素II等缩血管物质的情况下，钙拮抗剂可阻断入球小动脉的血管收缩。这些缩血管物质可能是肾毒素（如放射性造影剂和环孢素A）的介质。正在研究的钙拮抗剂在改善慢性肾病方面的潜在益处的作用包括：预防肾小球肥大、阻断血管紧张素II介导的大分子进入系膜细胞和细胞因子释放、自由基清除活性以及减少肾脏内的钙沉积。短期和长期试验均已证明钙拮抗剂可减缓肾病进展。目前正在进行进一步的研究。
