Effect of Verapamil on Kidney Function Using Radionuclide Imaging

Abstract

Background and Objective: Calcium channel blockers (CCBs) are among the most widely used prescribed drugs for the treatment of cardiovascular diseases. The present study investigates the effect of verapamil, which is most commonly used as a CCB, on kidney function using radionuclide imaging. Methods: Ten New Zealand white rabbits were used in vitro (4) and in vivo (6) studies. Isometric tensions were recorded for isolated renal artery ring segments, while renographic studies were performed using Technetium-99m mercaptoacetyltriglycine and Gamma camera. Time to peak activity (T_max) and time from peak to 50% activity (T_1/2), were calculated from the renograms for control and treated rabbits with verapamil. Results: In vitro, verapamil shifted the curve of phenylephrine concentration-dependent contraction on renal artery to the right, and decrease the highest contraction by 30 ± 3%. In vivo, the average values of T_max for control and treated rabbits were 2.8 ± 0.1 and 2.2 ± 0.2 min respectively. The T_1/2 for control and treated rabbits were 4.7 ± 0.05 and 4.2 ± 0.08 min respectively. The differences were statistically significant: p < 0.05. There is 30 ± 4% decrease in the 2 values. This indicates that there is a rapid renal uptake of the tracer and clearance of the radioactivity after verapamil. Conclusion: Verapamil dilates the renal artery and accelerates both the T_max and T_1/2 in the renogram. It increases renal blood perfusion and protects kidney function and therefore improves its work. However, verapamil should not be used while performing renograms to avoid misleading results.

Verapamil-Induced Hypotension in End-Stage Renal Disease: The Role of Calcium Gluconate

“…Verapamil can be used in patients with chronic kidney disease. In fact, verapamil has a vasodilatory effect on the renal arteries, causing an improvement in renal perfusion and ultimately protecting the kidney and improving its function [8]. The pharmacokinetics of verapamil is unaltered in patients with chronic kidney disease, and additional verapamil dosage is not required in end-stage renal disease patients post hemodialysis [2].…”