Rodicio J L
Department of Nephrology, Hospital 12 de Octubre, University of Madrid, Spain.
Blood Press Suppl. 1996;5:10-5.
The aim of this study was to review the effect of the calcium antagonists in general and manidipine hydrochloride in particular on the different renal haemodynamic parameters in experimental animals and human beings.
The paper includes data from experimental and human studies performed between 1978 and 1995.
As far as renal blood flow and glomerular filtration rate are concerned in experimental animals and in men, manidipine, a long-lasting dihydropyridine calcium antagonist, demonstrated its action not only on the afferent arteriole, as other dihydropyridines, but also on the efferent one. This action, which avoids producing any increase in intra-glomerular pressure and renal damage, would be similar to that of angiotensin converting enzyme inhibitors. The direct natriuretic effect of manidipine, observed also with other dihydropyridines, has been demonstrated by two studies performed in both spontaneously hypertensive and normotensive rats, indicating a direct renal tubular effect. In 5/6 nephrectomized rats treated with manidipine, blood pressure, proteinuria, serum creatinine and glomerular lesions, observed after histological examination, were significantly reduced with respect to control untreated 5/6 nephrectomized rats. Calcium antagonists have demonstrated a clear beneficial effect on renal vasoconstriction induced by cyclosporine therapy in renal transplant patients and in the prevention of acute renal failure secondary to the administration of radiocontrast agents, amphotoricin B, cisplatin and aminoglycosides.
Calcium antagonists are effective drugs for controlling blood pressure and for inducing renal vasodilatation. Manidipine hydrochloride increases renal blood flow and glomerular filtration rate with vasodilation of afferent as well as efferent arterioles, reducing intraglomerular pressure. According to experimental and human studies on renal haemodynamics, manidipine could be used in diabetic nephropathy, glomerular lesions, microalbuminuria and proteinuria.
本研究旨在综述钙拮抗剂尤其是盐酸马尼地平对实验动物和人类不同肾血流动力学参数的影响。
本文纳入了1978年至1995年间进行的实验研究和人体研究数据。
就实验动物和人类的肾血流量及肾小球滤过率而言，长效二氢吡啶类钙拮抗剂马尼地平不仅如其他二氢吡啶类药物一样作用于入球小动脉，还作用于出球小动脉。这种作用可避免肾小球内压升高及肾损伤，类似于血管紧张素转换酶抑制剂的作用。两项在自发性高血压大鼠和正常血压大鼠中进行的研究证实，马尼地平与其他二氢吡啶类药物一样具有直接利钠作用，表明其对肾小管有直接作用。在用马尼地平治疗的5/6肾切除大鼠中，与未治疗的对照5/6肾切除大鼠相比，经组织学检查观察到的血压、蛋白尿、血清肌酐及肾小球病变均显著减轻。钙拮抗剂已证明对肾移植患者环孢素治疗引起的肾血管收缩以及预防因使用造影剂、两性霉素B、顺铂和氨基糖苷类药物导致的急性肾衰竭具有明显的有益作用。
钙拮抗剂是控制血压和诱导肾血管舒张的有效药物。盐酸马尼地平可增加肾血流量和肾小球滤过率，使入球小动脉和出球小动脉血管舒张，降低肾小球内压。根据关于肾血流动力学的实验和人体研究，马尼地平可用于糖尿病肾病、肾小球病变、微量白蛋白尿和蛋白尿。
