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首页> 外文期刊>The Open Clinical Chemistry Journal >Change of Glomerular Hemodynamics in Patients with Advanced ChronicKidney Disease after Cilnidipine Therapy
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Change of Glomerular Hemodynamics in Patients with Advanced ChronicKidney Disease after Cilnidipine Therapy

机译：西尼地平治疗后慢性肾脏病晚期患者肾小球血流动力学的变化

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Cilnidipine, a dual calcium channel antagonist, is assumed to regulate hypertension via N- and L-type calciumchannel. The N-type calcium channel is associated with sympathetic nerve activation. This effect may improve the glomerularhemodynamics in the injured nephron, and may mitigate the progression of renal injury. To clarify the effect of cilnidipinein instances of already existing decreased renal blood flow, we examined the alteration of renal hemodynamicsbefore and after cilnidipine therapy in patients with advanced chronic kidney disease (CKD). Cilnidipine was administrateddaily to 17 CKD patients with hypertension for 12 months. Another 16 patients were similarly administered amlodipineduring this study, a long-acting L-type calcium channel antagonist has also been shown to be renoprotective.Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and protein excretion in 24-hour accumulated urinewere measured at the start and end of the study. The parameters of renal hemodynamics were calculated by Gomez’s estimationequation. Systolic blood pressure decreased to 80 % of the level at the beginning of the study, and ERPF increasedto 127 % of the level at baseline. Glomerular capillary pressure on single nephron was reduced to 90 %, althoughtotal GFR decreased within the non-statistical change. Especially, renal vascular resistance ratio (RA/RE) on single nephronimproved to 120 %. Cilnidipine improves ERPF and glomerular hypertension without worsening total renal function.N- and L-type calcium channel antagonist is effective and safe for patients with advanced CKD as a result of improvementof glomerular capillary resistance.
机译：西尼地平是一种双重钙通道拮抗剂，被认为可以通过N型和L型钙通道调节高血压。 N型钙通道与交感神经激活有关。该作用可以改善受伤的肾单位中的肾小球血流动力学，并且可以减轻肾脏损伤的进展。为了阐明西尼地平实例中已经存在的肾血流量减少的影响，我们检查了西尼地平治疗晚期慢性肾脏病（CKD）患者前后肾脏血液动力学的变化。每天对17名CKD高血压患者给予西尼地平12个月。在这项研究中，另外16名患者接受了氨氯地平类似的治疗，长效L型钙通道拮抗剂也被证明具有肾脏保护作用。肾小球滤过率（GFR），有效肾血浆流量（ERPF）和24小时内蛋白排泄在研究开始和结束时测量累积的尿液。肾血流动力学参数通过戈麦斯估计方程计算。在研究开始时，收缩压降至水平的80％，ERPF升高至基线水平的127％。单肾单位肾小球毛细血管压力降低至90％，尽管总GFR在非统计变化范围内降低。特别是，单个肾单位的肾血管阻力比（RA / RE）提高到120％。西尼地平可改善ERPF和肾小球性高血压，而不会损害总肾功能。N和L型钙通道拮抗剂由于肾小球毛细血管抵抗力的改善，对于晚期CKD患者是有效和安全的。

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