Renal effects of acute and long-term treatment with felodipine in essential hypertension

Ul, Hulthén; Pl, Katzman

doi:10.1097/00004872-198803000-00008

Cited by 49 publications

(22 citation statements)

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“…Renal hemodynamic findings after acute felodipine administration are indicative of a direct renal vasodilator action of felodipine. Our results on renal blood flow agree with the reports published by Anderson et al [24,25], Hulthen et al [8] and Leonetti et al [7], The 99mTc-MAG-! clearance value, estimated using Schlegel's [ 15] method for gamma camera, did not differ significant ly acutely and during long-term administration of the drug.…”

Section: Discussionsupporting

confidence: 93%

“…Acute and long-term effects of felodipine on renal functions have been investigated by several authors. Renal blood flow and glomerular filtra tion rate (GFR) have been reported to be unchanged by Ek et al [11], DiBona et al [ 10], Binetti et al [17], Jenkins et al [ 18] and Schmitz et al [5], while others observed an increase in renal flow and ERPF by felodipine [8,19], Herlitz et al [19] have reported an increase in GFR and only a slight increase in renal plasma flow during long term treatment of felodipine. They have concluded that felodipine has a relaxation effect on the afferent arteriole leading to an enhanced GFR.…”

Section: Discussionmentioning

confidence: 99%

“…It has also a wide spectrum of effects on the kidney [6]. It has been reported that felodipine reduces the increased renal vascular resistance in hypertensive rats and in patients with hypertension both after acute and chronic treatment [7,8], A decrease in renal vascular resistance, although dependent on the de crease in mean arterial pressure, may be associated with an increase in renal blood flow [9]. The diuretic and natri uretic effects of felodipine were reported to be due to the direct inhibitory effects of compounds on net renal tubu lar water and sodium reabsorption [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Scintigraphic Evaluation of the Short- and Long-Term Renal Effects of Oral Felodipine Using Technetium-99m-Mercaptoacetyl Triglycine

Özdemir¹,

Erbaş

Uğur

et al. 1993

Am J Nephrol

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The short- and long-term effect of felodipine on renal perfusion and tubular function was investigated using a new renal tubular imaging agent, ^99mTc-mercaptoacetyl triglycine (^99mTc-MAG3). Twelve patients with essential hypertension (mean age = 49 + 8 years) were studied. Renal scintigraphies with 180 MBq ^99mTc-MAG3 were performed at baseline, at the 2nd hour following oral administration of 5 mg felodipine and 4 weeks later on 5-10 mg daily felodipine therapy. The time-activity curves of each kidney were obtained following background subtraction. The ^99mTc-MAG3 clearance value was measured for each kidney. In addition, perfusion index (PI), reno index, time to maximum, half-maximum and two thirds of maximum activity values of each kidney were calculated. Systolic and diastolic blood pressures were significantly lowered with long-term administration of felodipine (from 159 ± 12/105 ± 5 to 141 ± 11/87 ± 7 mm Hg, p = 0.01 and p = 0.002, respectively). Heart rate did not change significantly. Initially, a decrease in PI indicating an increase in renal blood flow (from 246 ± 96 to 194 ± 54, p= 0.01) was observed, whereas no change was noted during the chronic administration (to 230 ± 69, p = NS). Total clearance of ^99mTc-MAG3 was decreased nonsignificantly following the initial dose of felodipine (from 361 ± 93 to 351 ± 91 ml/ min, p = NS). During long-term therapy, felodipine did not alter the perfusion and tubular function of the kidneys. Our results indicated that felodipine causes a significant increase in renal blood flow initially, even with a nonsignificant change in systemic blood pressure.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Scintigraphic Evaluation of the Short- and Long-Term Renal Effects of Oral Felodipine Using Technetium-99m-Mercaptoacetyl Triglycine

Özdemir¹,

Erbaş

Uğur

et al. 1993

Am J Nephrol

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“…In addition, ferodipine is effective both in healthy normotensive volunteers (7) and in hypertensive subjects (8). In such studies, nifedipine-induced urico suria was shown to be related to an increase in the glo merular filtration rate (GFR) and in renal plasma flow (1).…”

mentioning

confidence: 99%

“…In such studies, nifedipine-induced urico suria was shown to be related to an increase in the glo merular filtration rate (GFR) and in renal plasma flow (1). In contrast, it was suggested that the uricosuric effects of ferodipine (8) and manidipine (5) might be mediated mainly via a tubular action because of the absence of any change in GFR.…”

mentioning

confidence: 99%

A Comparison of the Uricosuric Effects in Rats of Diltiazem and Derivatives of Dihydropyridine (Nicardipine and Nifedipine).

Sugino

Shimada

1997

Jpn.J.Pharmacol

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Effects of Calcium Antagonists on Renal Hemodynamics and Progression of Nondiabetic Chronic Renal Disease

Wee¹

1994

Arch Intern Med

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In recent years, substantial investigative attention has focused on therapeutic regimens that could retard the progression of chronic renal insufficiency. Emphasis has been placed on the effects of antihypertensive treatment on renal hemodynamics and preservation of renal function. It has been suggested that some classes of antihypertensive agents may confer a greater renoprotective effect, especially agents that lower glomerular capillary pressure. Conversely, by virtue of their ability to preferentially dilate the afferent arteriole calcium antagonists theoretically could favor an increase in glomerular capillary pressure thereby accelerating the decline of renal function. In this review we survey the literature critically and conclude that in patients with essential hypertension and in patients with chronic renal insufficiency, calcium antagonists effectively reduce systemic blood pressure while maintaining glomerular filtration rate and effective renal plasma flow. Preliminary results from a few long-term studies suggest that calcium antagonists may even attenuate the decline in renal function of patients with chronic renal failure. The majority of studies in humans, however, have been nonrandomized, of too short duration, or confounded by investigative difficulties precluding definite conclusions whether calcium antagonists have renoprotective effects. Although the possibility that calcium antagonists may retard progression of renal disease remains to be ascertained, the available evidence indicates that calcium antagonists may be used in patients with renal functional impairment without further exacerbating renal function. (Arch Intern Med. 1994;154:1185-1202) Systemic hypertension complicates the clini¬ cal course of most patients with chronic re¬ nal failure and can accelerate the deterio¬ ration of renal function.1"3 Experimental studies in animals have demonstrated that treatment of systemic hypertension delays the progression of chronic renal insuffi¬ ciency.4"6 In humans, results of epidemio-logic79 and several clinical studies1014 indi¬ cate that treatment of systemic hypertension can also arrest the decline in renal func¬ tion. Prospective randomized studies on this subject, however, are lacking. The mechanisms wherebysystemic hy¬ pertension induces glomerular injury and increases the rate of progression of chronic renal failure have not been fully elucidated.Experimental studies have demonstrated that the sustained increase in glomerular capillarypressure evoked in response to loss of renal mass produces a destructive sclerosing reaction.46 Administration of angiotensin-converting enzyme (ACE) in¬ hibitors decreases glomerular capillarypres¬ sure with a resultant reduction of glomeru¬ lar sclerosis, suggesting that ACE-inhibitor therapymayprotect the injuredkidney from hemodynamically mediated glomerular damage.5 Conversely, it has been proposed that because calcium antagonists preferen¬ tially dilate the afferent arteriole,1516 they should theoretically favor an increase in glo¬ merular capillary ...

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Renal effects of acute and long-term treatment with felodipine in essential hypertension

Cited by 49 publications

References 0 publications

Scintigraphic Evaluation of the Short- and Long-Term Renal Effects of Oral Felodipine Using Technetium-99m-Mercaptoacetyl Triglycine

Scintigraphic Evaluation of the Short- and Long-Term Renal Effects of Oral Felodipine Using Technetium-99m-Mercaptoacetyl Triglycine

A Comparison of the Uricosuric Effects in Rats of Diltiazem and Derivatives of Dihydropyridine (Nicardipine and Nifedipine).

Effects of Calcium Antagonists on Renal Hemodynamics and Progression of Nondiabetic Chronic Renal Disease

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