Korean Journal of Nephrology 2010;29(3):322-328.
Effect of Efonidipine on Proteinuria in Patients with Chronic Kidney Disease Receiving RAS Blockade
Jung-Kook Wi, M.D.1, Kyung-Whan Jeong, M.D.1, Tae-Won Lee, M.D.1, Sang-Ho Lee, M.D.1, Ju-Young Moon, M.D.1, Dae Ryong Cha, M.D.2, Sung-Kyu Ha, M.D.3, Soon Bae Kim, M.D.4, Ihm Soo Kwak, M.D.5 and Chun-Gyoo Ihm, M.D.1
Deparyment of Nephrology1
College of Medicine, Kyunghee University, Seoul, Korea, Department of Nephrology2
Korea University Ansan Hospital, Ansan City, Korea, Department of Internal Medicine Yonsei University College of Medicine3
Gangnam Severance Hospital, Seoul, Korea, Department of Internal Medicine4
Division of Nephrology, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea, Department of Internal Medicine5
Pusan National University School of Medicine, Pusan, Korea
원저 : 만성신질환 환자에서 레닌-안지오텐신 차단제와 efonidipine 병합요법이 단백뇨에 미치는 효과에 대한 다기관 관찰 연구
위정국1 , 정경환1 , 이태원1 , 이상호1 , 문주영1, 차대룡2 , 하성규3 , 김순배4 , 곽임수5 , 임천규1
경희대학교 의과대학 신장내과1 , 고려대학교 의과대학 신장내과2, 연세대학교 의과대학 신장내과3 , 울산대학교 의과대학 신장내과4 , 부산대학교 의과대학 신장내과5
Abstract
Purpose : Efonidipine, which inhibits both T- and L-type calcium channels, has been shown to be effective in reducing proteinuria and preserve renal function. This study was conducted to compare the effects of efonidipine versus amlodipine on the management of hypertension and proteinuria in patients with chronic kidney disease (CKD) receiving ACE inhibitors or ARB. Methods : This study included 41 CKD patients who were at stages 2-4 and had a urine spot protein/ creatinine ratio of >0.5. Patients were administered amlodipine (5 mg/day) and efonidipine (40 mg/ day) for 3 months in a cross-over design. Blood pressure and spot urine protein/creatinine ratio were compared before and after the cross-over treatment. Results : There were 24 male patients and 17 female patients. The mean age of the patients was 55.9±12.9 years. When the patients’ medication was changed to eponidifine, we obtained the following results. First, there were no significant changes in blood pressure and serum creatinine. Second, the urine spot protein/creatinine ratio was significantly decreased (before the cross-over, 2.9±2.6; after the cross-over, 2.3±1.9 g/g; p=0.02). Finally, the reduction rate of proteinuria was significantly higher in patients with CKD at stages 2-3 than in those with CKD at stage 4 after the cross-over (stage 2, - 26.1%; stage 3, -17%; stage 4, +12.8%; p=0.03). Conclusion : It is concluded that efonidipine may significantly decrease proteinuria compared with amlodipine in CKD patients receiving ACE inhibitors or ARB. Further double-blind clinical trials with a larger sample size are needed to confirm our results.
Key Words: ium channel blocker, Efonidipine, Amlodipine, Proteinuria


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