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Vol. 99, No. 1, 2005
Issue release date: January 2005
Section title: Original Paper
Nephron Clin Pract 2005;99:c18–c23
(DOI:10.1159/000081790)

Calcium Channel Blocker versus Angiotensin II Receptor Blocker in Autosomal Dominant Polycystic Kidney Disease

Nutahara K. · Higashihara E. · Horie S. · Kamura K. · Tsuchiya K. · Mochizuki T. · Hosoya T. · Nakayama T. · Yamamoto N. · Higaki Y. · Shimizu T.
aDepartment of Urology, Kyorin University School of Medicine, Tokyo; bDepartment of Urology, Teikyo University School of Medicine, Tokyo; cDepartment of Urology, Sakura National Hospital, Sakura; dDepartment of Medicine, Kidney Center, Tokyo Women’s Medical University, Tokyo; eDepartment of Internal Medicine, Hokkaido University Graduate School of Medicine, Sapporo; fDepartment of Kidney and Hypertension, Jikei University School of Medicine, Tokyo; gDepartment of Internal Medicine, Nihon University School of Medicine, Tokyo; hDepartment of Urology, Hikari City General Hospital, Hikari; iDepartment of Urology, National Hospital, Tokyo Disaster Medical Center, Tokyo, and jDepartment of Clinical Genetics, Kyorin University School of Health Sciences, Tokyo, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 12/9/2003
Accepted: 6/22/2004
Published online: 1/14/2005

Number of Print Pages: 1
Number of Figures: 4
Number of Tables: 1

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background: Although hypertension is commonly found in patients with autosomal dominant polycystic kidney disease (ADPKD), there is no consensus about which antihypertensive agents are most appropriate. The effects of calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB) on blood pressure and renoprotection were compared in hypertensive patients with ADPKD. Methods: We randomly assigned 49 participants to CCB amlodipine-based (2.5–10 mg/day) or ARB candesartan-based (2–8 mg/day) regimens. Twenty-five patients (13 males and 12 females) received amlodipine, and 24 patients (13 males and 11 females) received candesartan. This was followed up for 36 months. Results: Baseline characteristics were similar, and blood pressure was well controlled in both groups throughout the study period. Six out of 25 (24.0%) amlodipine and 1 out of 24 (4.2%) candesartan patients were terminated from the protocol due to a twofold increase in serum creatinine and/or decrease in creatinine clearance (Ccr) to half of the baseline. The renal event-free survival rate was significant (p < 0.05, Breslow-Gehan-Wilcoxon test). Serum creatinine was higher in the amlodipine group than in the candesartan group at 24 and 36 months (p < 0.05). The decrease in Ccr at 36 months was larger in the amlodipine group than in the candesartan group (ΔCcr: –20.9 ± 13.1 vs. –4.8 ± 13.8 ml/min, p < 0.01). Urinary protein excretion was significantly lower in the candesartan group than in the amlodipine group at 36 months. Urinary albumin excretion was significantly lower in the candesartan group than in the amlodipine group at 12, 24 and 36 months. Conclusions: The renoprotective effect of candesartan is considered more favorable than amlodipine in the treatment of ADPKD. This is independent of the antihypertensive effect per se.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 12/9/2003
Accepted: 6/22/2004
Published online: 1/14/2005

Number of Print Pages: 1
Number of Figures: 4
Number of Tables: 1

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

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    External Resources

  19. Delles C, Klingbeil AU, Schneider MP, et al: Direct comparison of the effects of valsartan and amlodipine on renal hemodynamics in human essential hypertension. Am J Hypertens 2003;16:1030–1035.