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- Title
Long-term effects of felodipine in patients with reduced renal function.
- Authors
HERLITZ, HANS
- Abstract
To characterize the long-term effects of calcium antagonists on renal function in hypertension felodipine was used to treat 14 patients with severe uncontrolled hypertension associated with renal functional impairment: six patients had renal parenchymal hypertension, six had essential hypertension and two had renovascular hypertension. Mean blood pressure was 197 ± 2/115 ± 3 mm Hg despite treatment with three or more antihypertensive drugs. Mean glomerular filtration rate (GFR) was 39 ± 6 ml/min (Cr-EDTA clearance) before initiation of felodipine treatment. All patients experienced a blood pressure reduction after starting felodipine treatment, which persisted during long-term therapy in combination with previous medication except former vasodilating drugs. Blood pressure after 12 and 24 months was 152 ± 7/89 ± 2 and 157 ± 5/90 ± 2 mm Hg. respectively. Patients with moderately impaired GFR and absence of progressive renal disease (N = 8) manifested an increase in GFR after 6 and 12 months on felodipine (59 ± 10 to 63 ± 7 and 70 ± 6 ml/min, respectively, P < 0.05). Renal plasma flow (PAH clearance) exhibited only a slight increase (315 ± 68 to 340 ± 63 and 314 ± 69 ml/min) with a consequent increase in filtration fraction (18 ± 1 to 21 ± 1 and 20 ± 1%, NS). At follow-up after six to eight years patients with initial GFR ≥ 50 ml/min had a maintained renal function. In five patients a progressive deterioration of renal function had been documented. After initiation of felodipine treatment the rate of decline in kidney function, expressed as decrease in GFR (ml/min/year), decreased from 9.6 ± 2.3 to 4.3 ± 1.4 ml/min/year. We conclude that felodipine decreases blood pressure in patients with previously refractory hypertension, and that the drug has beneficial effects on renal function.
- Subjects
RENAL circulation; KIDNEY blood-vessels; BLOOD circulation; CALCIUM antagonists; CARDIOVASCULAR agents; DRUGS
- Publication
Kidney International Supplement, 1992, Issue 36, pS-110
- ISSN
0098-6577
- Publication type
Article
- DOI
10.1111/1523-1755.ep15066661