International Journal of Medical Sciences

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24 October 2017

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Int J Med Sci 2013; 10(9):1209-1216. doi:10.7150/ijms.5508

Research Paper

Comparison of the Antialbuminuric Effects of L-/N-type and L-type Calcium Channel Blockers in Hypertensive Patients with Diabetes and Microalbuminuria: The Study of Assessment for Kidney Function by Urinary Microalbumin in Randomized (SAKURA) Trial

Katsuayuki Ando1✉, Kenji Ueshima2, Sachiko Tanaka2, Shinji Kosugi3, Tosiya Sato4, Hiroaki Matsuoka5, Kazuwa Nakao2,6, Toshiro Fujita7

1. Department of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
2. EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
3. Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
4. Department of Biostatistics, Kyoto University School of Public Health, Kyoto, Japan
5. Utsunomiya Chuoh Hospital, Tochigi, Japan
6. Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
7. Division of Clinical Epigenetics, Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan

Abstract

Objective: To clarify whether the L-/N-type calcium channel blocker (CCB) cilnidipine is more renoprotective than the L-type CCB amlodipine in patients with early-stage diabetic nephropathy.

Methods: In this prospective, multicenter, open-labeled, randomized trial, the antialbuminuric effects of cilnidipine and amlodipine were examined in renin-angiotensin system (RAS) inhibitor-treated patients with hypertension (blood pressure [BP]: 130-180/80-110 mmHg), type 2 diabetes, and microalbuminuria (urinary albumin to creatinine [Cr] ratio [UACR]: 30-300 mg/g).

Results: Patients received cilnidipine (n = 179, final dose: 10.27 ± 4.13 mg/day) or amlodipine (n = 186, 4.87 ± 2.08 mg/day) for 12 months. Cilnidipine and amlodipine equally decreased BP. The UACR values for the cilnidipine and amlodipine groups were 111.50 ± 138.97 and 88.29 ± 63.45 mg/g, respectively, before treatment and 107.93 ± 130.23 and 89.07 ± 97.55 mg/g, respectively, after treatment. The groups showed similar changes for the natural logarithm of the UACR, serum Cr, and estimated glomerular filtration rate.

Conclusions: Cilnidipine did not offer greater renoprotection than amlodipine in RAS inhibitor-treated hypertensive patients with type 2 diabetes and microalbuminuria.

Keywords: L-/N-type Calcium Channel Blocker, Urinary Albumin, Diabetic Nephropathy, Hypertension, Renin-Angiotensin System Inhibitor

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How to cite this article:
Ando K, Ueshima K, Tanaka S, Kosugi S, Sato T, Matsuoka H, Nakao K, Fujita T. Comparison of the Antialbuminuric Effects of L-/N-type and L-type Calcium Channel Blockers in Hypertensive Patients with Diabetes and Microalbuminuria: The Study of Assessment for Kidney Function by Urinary Microalbumin in Randomized (SAKURA) Trial. Int J Med Sci 2013; 10(9):1209-1216. doi:10.7150/ijms.5508. Available from http://www.medsci.org/v10p1209.htm