Why the study?
Amlodipine and second-generation dihydropyridine calcium channel blockers do not improve renal outcomes or eliminate intraglomerular hypertension in hypertensive patients with chronic kidney disease, prompting evaluation of newer agents.
Do newer dihydropyridine calcium channel blockers (lercanidipine, benedipine, cilnidipine) improve renoprotective outcomes compared to older generations in hypertensive patients with chronic kidney disease?
Do newer dihydropyridine calcium channel blockers (lercanidipine, benedipine, cilnidipine) improve renoprotective outcomes compared to older generations in hypertensive patients with chronic kidney disease?
Newer generation dihydropyridine calcium channel blockers like lercanidipine, benedipine, and cilnidipine may offer superior renoprotection in hypertensive patients with CKD compared to older agents like amlodipine.
Answers are grounded in this paper and cite their sources.
Caution against adding second-generation dihydropyridine CCBs for renal protection in hypertensive CKD; leaves open need for intraglomerular pressure-targeted trials.
Amlodipine and selective dihydropyridine Ca 2 + channels blockers of the second generation in addition to ACE inhibitors or replacing them antagonists of AT1-angiotensin receptors don’t improve clinical renal outcomes in hypertensive patients with chronic kidney disease. These drugs don’t eliminate intraglomerular hypertension that underlies hypertensive nephropathy and can have an adverse effect on the neurohormonal status of the organism, triggering the activation of the sympathetic and renin-angiotensin-aldosterone systems. The review presents the results of clinical studies evaluating the effectiveness of the use in this patients population of a new dihydropyridine blocker L-Ca 2 + channels third-generation lercanidipine, dual blocker T/L-Ca 2 + channels benedipine and dual blocker N/L-Ca2+ channels cilnidipine, that differ from their predecessors expressed renoprotective properties.
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Ob et al. (2021) studied this question.
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