Diuretic and natriuretic effects of nifedipine in healthy persons.

Wetzels, Jack F.M.; Wiltink, P. G.; Hoitsma, Andries J.; Huysmans, F. T. M.; Koene, R. A. P.

doi:10.1111/j.1365-2125.1988.tb03344.x

Cited by 19 publications

(12 citation statements)

References 17 publications

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“…We found that the natriuretic effect after felodipine treatment tended to be more pronounced than that after placebo, but this difference between felodipine treatment and placebo was not significant. This tendency is in accordance with other acute studies in healthy subjects [6,7,[10][11][12][13][14][15][16] in which calcium antagonists belonging to the dihydropyridine class have a natriuretic and diuretic effect. The mechanisms underlying these effects are presumed to be direct effects on the kidney, promoting decreased reabsorption of sodium in the tubules [8,10,13,14].…”

Section: Discussionsupporting

confidence: 93%

“…This is in agreement with our findings where BP was significantly reduced and HR was significantly increased by felodipine treatment. Vasodilatation and BP reduction would cause salt and water retention, but natriuretic and diuretic effects of calcium channel blockers prevent these side effects [6][7][8][9][10][11][12][13][14][15][16]. We found that the natriuretic effect after felodipine treatment tended to be more pronounced than that after placebo, but this difference between felodipine treatment and placebo was not significant.…”

Section: Discussionmentioning

confidence: 70%

“…In chronic furosemide treatment this increased distal sodium and water delivery causes a compensatory up-regulation of sodium transporters distally to the primary site of diuretic action, thus increasing sodium reabsorption capacity and reducing the loss of sodium [23]. Felodipine treatment results in a reduction in BP caused by vasodilatation and in an increase in HR due to a reflex increase in sympathetic tone [6][7][8][9][10][11][12][13][14][15][16]. This is in agreement with our findings where BP was significantly reduced and HR was significantly increased by felodipine treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In healthy humans, dihydropyridine derivatives of calcium channel blockers have natriuretic and diuretic effects, which counteract the salt and water retention expected from vasodilatation and blood pressure (BP) reduction [6][7][8][9][10][11][12][13][14][15][16]. Calcium antagonists act on proximal as well as distal sites in the nephron.…”

Section: Introductionmentioning

confidence: 99%

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Urinary excretion of aquaporin‐2 after furosemide and felodipine in healthy humans

Starklint

Bech

Pedersen

2005

Scandinavian Journal of Clinical and Laboratory Investigation

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Urinary excretion of aquaporin‐2 after furosemide and felodipine in healthy humans

Starklint

Bech

Pedersen

2005

Scandinavian Journal of Clinical and Laboratory Investigation

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“…It has also been reported that CCBs, especially those of the dihydropyridine class, increase urinary sodium and water excretion, partly by decreasing proximal tubular sodium reabsorption. 21,22 In addition, CCBs have been proven to be effective in preventing arteriosclerosis, 23,24 whereas diuretics can damage the sugar/fat metabolism system, 25,26 a possible factor in exacerbation of atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Angiotensin II receptor blocker and long-acting calcium channel blocker combination therapy decreases urinary albumin excretion while maintaining glomerular filtration rate

et al. 2011

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, the NICE-Combi Study GroupMicroalbuminuria is a recognized risk factor and predictor for cardiovascular events in patients with hypertension. We analyzed changes in hypotensive effect, urinary albumin excretion (UAE) and estimated glomerular filtration rate (eGFR) in subjects with hypertension and microalbuminuria as a subanalysis of the results of the Nifedipine and Candesartan Combination (NICE-Combi) Study. A total of 86 subjects with essential hypertension with microalbuminuria (UAE o300 mg g À1 creatinine) were randomly assigned in a double-blind manner to a combination therapy group (standard-dose candesartan at 8 mg per day plus controlledrelease (CR) nifedipine 20 mg per day) (n¼42) or an up-titrated monotherapy group (candesartan 12 mg per day) (n¼44) for 8 weeks of continuous treatment after initially receiving standard-dose candesartan (8 mg per day) monotherapy for 8 weeks (initial treatment). After 8weeks, blood pressure (BP) was significantly reduced in both groups compared with at the end of initial treatment. UAE also showed a significant decrease in the combination therapy group, while there was no significant change of eGFR in either group. A significant positive correlation was seen between BP reduction and UAE after 8 weeks of double-blind treatment in both groups, whereas no significant association was found between DUAE and DeGFR in either group. These findings show that combination therapy with standard-dose candesartan and nifedipine CR is more effective than up-titrated candesartan monotherapy for reducing BP and improving UAE while maintaining eGFR, and strongly suggest that the combination of an angiotensin II receptor blocker and long-acting calcium channel blocker is beneficial in patients with hypertension and microalbuminuria.

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Nitrendipine and Renal Tubular Function in Human Volunteers

Forsyth

Roberts

1992

The Journal of Clinical Pharma

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Nine normotensive, water-loaded subjects received 10 mg oral nitrendipine, and eight subjects received placebo in a double-blind randomized manner. Urine and plasma were collected at fixed time points for 1 hour before and for 4 hours after drug administration for biochemical measurements. Glomerular filtration rate was measured by inulin clearance and effective renal blood flow was measured by para-amino hippurate clearance. Absolute sodium excretion increased by 25.9% from 0.27 +/- 0.03 mmol/min to 0.34 +/- 0.02 mmol/min (P = .02), and fractional sodium excretion increased by 32.3% from 18.9 +/- 3.0% to 25.0 +/- 1.9% (P = .03) after nitrendipine, but both were unchanged after placebo. There was no change in inulin clearance, para-amino hippurate clearance, urine volume, or fractional excretion of uric acid, which made an effect on glomerular filtration, renal blood flow, or proximal tubular function an unlikely explanation of the natriuresis. Fractional excretion of magnesium increased after both placebo and nitrendipine administration, from 5.0 +/- 0.6% to 6.8 +/- 0.7% (P = .027) and 5.7 +/- 0.8% to 8.8 +/- 1.0% (P = .006), respectively. Fractional excretion of phosphate also increased after both placebo and nitrendipine, from 9.5 +/- 2.3% to 12.9 +/- 3.9% (P = .05) and 9.7 +/- 1.7% to 14.2 +/- 1.9% (P = .002), respectively. These changes are likely to be due to the effects of the water load rather than due to a drug effect. There was no change in clearance of solute free water, which made a direct effect on the loop of Henle or cortical diluting segment unlikely.(ABSTRACT TRUNCATED AT 250 WORDS)

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Diuretic and natriuretic effects of nifedipine in healthy persons.

Abstract: 1 We have studied the diuretic and natriuretic effects and the tubular site of action of nifedipine using free water clearance (CH20) and lithium clearance.

Cited by 19 publications

References 17 publications

Urinary excretion of aquaporin‐2 after furosemide and felodipine in healthy humans

Urinary excretion of aquaporin‐2 after furosemide and felodipine in healthy humans

Angiotensin II receptor blocker and long-acting calcium channel blocker combination therapy decreases urinary albumin excretion while maintaining glomerular filtration rate

Nitrendipine and Renal Tubular Function in Human Volunteers

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