Calcium channel blocker in patients with chronic kidney disease

Abstract

Background Chronic kidney disease (CKD) is involved in a progressive deterioration in renal function over the years and is now a global public health problem. Currently, reducing the number of patients progressing to end-stage renal failure is urgently necessary. Hypertension and CKD interact with each other, and good control of blood pressure (BP) can improve CKD patients’ prognosis. With the current global trend for more strict BP control, the importance of BP management and the need for medication to achieve this strict goal are increasing. Calcium channel blockers (CCBs), which target voltage-dependent calcium channels, are frequently used in combination with renin–angiotensin–aldosterone system inhibitors for CKD patients because of their strong BP-lowering properties and relatively few adverse side effects. Calcium channels have several subtypes, including L, N, T, P/Q, and R, and three types of CCBs, L-type CCBs, L-/T-type CCBs, and L-/N-type CCBs, that are available. Nowadays, the new functions and effects of the CCBs are being elucidated. Conclusion We should use different types of CCBs properly depending on their pharmacological effects, such as the strength of antihypertensive effects and the organ protection effects, taking into account the pathophysiology of the patients. In this article, the role and the use of CCBs in CKD patients are reviewed.

N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis

“…T-type calcium channels are also located in the inner medullary collecting ducts, distal collecting ducts, and collecting tubules [ 45 ]. N-type and T-type CCB can improve glomerular and tubular injury independently of hypotensive effect, which is superior to L-type CCB [ 14 , 46 ]. Cinidipine is an L/N-type CCB, which can reduce BP, inhibit the increase in blood urea nitrogen and the decrease in creatinine clearance, and improve glomerulosclerosis in Dahl salt-sensitive rats [ 47 ].…”

“…In addition, the blockade of these calcium channels has resulted in different effects on renal microcirculation [ 13 ]. Calcium channel blockers (CCB) targeting voltage-dependent calcium channels are frequently used in combination with renin–angiotensin–aldosterone system (RAAS) inhibitors for CKD patients because of their strong BP-lowering properties and relatively few adverse side effects [ 14 ]. When treatment with ACEI/ARB failed to reach the target of BP, ACEI/ARB in combination with CCB should be considered.…”

Eye Lesions in Patients After One Year of Kidney Transplantation

“…However, calcium channel blockers are used most significantly due to their rapid and safe hypotensive properties in patients with renal insufficiency. 14 After kidney transplantation, this class of drugs is also still preferred over the rest of the group. Six patients developed diabetes mellitus after transplantation.…”

Impact of calcium channel blockers and angiotensin receptor blockers on hematological parameters in type 2 diabetic patients

“…This, in turn, contributes to the amelioration of renal hypoxia. Furthermore, the actual reduction in albumin excretion has been linked to the renoprotective potential of these agents (22,23). Moreover, besides to blocking angiotensin II (AT2)related kidney injuries, ARBs can lower AT2 levels intra-renally by lowering renin and angiotensinogen of proximal tubules and collecting duct, preventing AT2 build-up in the kidneys (24).…”