Key result
Diltiazem improves GFR by ~48% in hypertensive patients with impaired baseline renal function.
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Prospective study shows diltiazem lowers blood pressure while preserving kidney function in primary hypertension, suggesting protective renal filtration gains in patients with baseline impairment.
Although the calcium channel blocker diltiazem has been shown to be an effective antihypertensive agent, its effect on renal function, salt and water excretion, and body fluid composition has not been well characterized in patients with primary hypertension. Therefore, these parameters were prospectively studied in 18 subjects with primary hypertension after placebo and 8 weeks of diltiazem monotherapy. Diltiazem monotherapy was confirmed to be an effective antihypertensive agent. Although mean arterial pressure was reduced from 121 to 108 mm Hg, diltiazem had no overall effect on glomerular filtration rate, renal plasma blood flow, salt and water excretion, or body fluid composition. Renal vascular resistance, however, was decreased. In subjects with pretreatment glomerular filtration rates of 80 ml/min/1.73 m2 or less, diltiazem therapy was associated with marked improvement in glomerular filtration rate (48%) and effective renal plasma flow (36%). Since the filtration fraction was unchanged, changes in glomerular filtration rate may have been related to the attenuated intrarenal effects of angiotensin II or norepinephrine, or both.
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Sunderrajan et al. (1986) studied Primary hypertension (n=18). Diltiazem vs. Placebo was evaluated on Renal function, salt and water excretion, and body fluid composition. Diltiazem monotherapy reduced mean arterial pressure from 121 to 108 mm Hg and improved glomerular filtration rate by 48% in subjects with baseline GFR ≤80 ml/min/1.73 m2.
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