Reno protective role of amlodipine in patients with hypertensive chronic kidney disease.

Georgi Abraham, A Almeida, Kumar Gaurav, Mohammed Yunus Khan, Usha Rani Patted, Maithrayie Kumaresan
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Abstract

Chronic kidney disease (CKD) and hypertension (HTN) are closely associated with an overlapping and intermingled cause and effect relationship. Decline in renal functions are usually associated with a rise in blood pressure (BP), and prolonged elevations in BP hasten the progression of kidney function decline. Regulation of HTN by normalizing the BP in an individual, thereby slowing the progression of kidney disease and reducing the risk of cardiovascular disease, can be effectively achieved by the anti-hypertensive use of calcium channel blockers (CCBs). Use of dihydropyridine CCBs such as amlodipine (ALM) in patients with CKD is an attractive option not only for controlling BP but also for safely improving patient outcomes. Vast clinical experiences with its use as monotherapy and/or in combination with other anti-hypertensives in varied conditions have demonstrated its superior qualities in effectively managing HTN in patients with CKD with minimal adverse effects. In comparison to other counterparts, ALM displays robust reduction in risk of cardiovascular endpoints, particularly stroke, and in patients with renal impairment. ALM with its longer half-life displays effective BP control over 24-h, thereby reducing the progression of end-stage-renal disease. In conclusion, compared to other classes of CCBs, ALM is an attractive choice for effectively managing HTN in CKD patients and improving the overall quality of life.

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氨氯地平对高血压慢性肾病患者的雷诺保护作用。
慢性肾脏病(CKD)和高血压(HTN)密切相关,因果关系交错重叠。肾功能衰退通常与血压(BP)升高有关,而血压长期升高会加速肾功能衰退。使用钙通道阻滞剂(CCBs)可以有效地通过使血压正常来调节高血压,从而减缓肾脏疾病的进展并降低心血管疾病的风险。在慢性肾脏病患者中使用氨氯地平(ALM)等二氢吡啶类钙通道阻滞剂不仅能控制血压,还能安全地改善患者的预后,是一种很有吸引力的选择。氨氯地平作为单药和/或与其他降压药联合应用于各种情况下的大量临床经验表明,氨氯地平在有效控制 CKD 患者高血压方面具有卓越的品质,且不良反应极小。与其他同类药物相比,ALM 能显著降低心血管终点(尤其是中风)的风险,对肾功能受损的患者也是如此。半衰期较长的 ALM 可在 24 小时内有效控制血压,从而减少肾脏疾病晚期的进展。总之,与其他类氯苯类药物相比,ALM 是有效控制慢性肾脏病患者高血压并改善其整体生活质量的理想选择。
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