Effects of Different Calcium Antagonists on Proteinuria Associated with Diabetes Mellitus
Authors: B K Demarie, G L Bakris
Journal: Annals of Internal Medicine (1990)

Brief Reports15 December 1990Effects of Different Calcium Antagonists on Proteinuria Associated with Diabetes MellitusBryan K. Demarie, MD, George L. Bakris, MDBryan K. Demarie, MD, George L. Bakris, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-12-987 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptStudies in various animal models of renal dysfunction show that urinary protein excretion is partly determined by glomerular capillary pressure (1-5). Further, clinical studies have shown that nifedipine, an agent that does not alter glomerular capillary pressure, increases urinary protein excretion and leads to renal dysfunction (6-8). In addition, diltiazem, an agent that lowers glomerular capillary pressure, decreases urinary protein excretion in a manner similar to that of angiotensin-converting enzyme inhibitors in diabetic patients with renal insufficiency and hypertension (9). We conducted a prospective crossover trial to evaluate the effects of diltiazem and nifedipine on urinary protein excretion in diabetic,...References1. Anderson S, Clarey L, Riley S, and Troy J. Acute infusion of calcium channel blockers reduces glomerular capillary pressure in rats with reduced renal mass [Abstract]. Kidney Int. 1988;33:370A. Google Scholar2. Eisenbach G, Van Liew J, and Boylan J. Effect of angiotensin on the filtration of protein in the rat kidney: a micropuncture study. Kidney Int. 1975;8:80-7. CrossrefMedlineGoogle Scholar3. Yoshioka T, Shiraga H, and Yoshida Y. "Intact nephrons" as the primary origin of proteinuria in chronic renal disease. J Clin Invest. 1988;82:1614-23. CrossrefMedlineGoogle Scholar4. Zatz R, Dunn B, Meyer T, Anderson S, Rennke H, and Brenner B. Prevention of diabetic glomerulopathy by pharmacological amelioration of glomerular capillary hypertension. J Clin Invest. 1986;77:1925-30. CrossrefMedlineGoogle Scholar5. Remuzzi A, Puntorieri S, Battaglia C, Bertani T, and Remuzzi G. Angiotensin converting enzyme inhibition ameliorates glomerular filtration of macromolecules and water and lessens glomerular injury in the rat. J Clin Invest. 1990;85:541-9. CrossrefMedlineGoogle Scholar6. Mimran A, Insua A, Ribstein J, Monnier L, Bringer J, and Mirouse J. Contrasting effects of captopril and nifedipine in normotensive patients with incipient diabetic nephropathy. J Hypertens. 1988;6:919-23. CrossrefMedlineGoogle Scholar7. Diamond J, Cheung J, and Fang L. Nifedipine-induced renal dysfunction. Am J Med. 1984;77:905-9. CrossrefMedlineGoogle Scholar8. Dworkin L and Benstein J. Impact of anti-hypertensive therapy on progressive kidney damage. Am J Hypertens. 1989;2:1625-725. CrossrefGoogle Scholar9. Bakris G. Effects of diltiazem or lisinopril on massive proteinuria associated with diabetes mellitus. Ann Intern Med. 1990;112:701-2. LinkGoogle Scholar10. Isshiki T, Amodeo C, Messerli F, Pegram B, and Frohlich E. Diltiazem maintains renal vasodilation without hyperfiltration in hypertension: studies in essential hypertensive man and spontaneously hypertensive rat. Cardiovascular Drugs and Therapy. 1987;1:359-66. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Bryan K. Demarie, MD; George L. Bakris, MDFrom the Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBlood pressure control in type 2 diabetic patientsBlood pressure and antihypertensive medication profile in a multiethnic Asian population of stable chronic kidney disease patientsManaging hypertension in diabetesTreating hypertension in type 2 diabetesAntihypertensive DrugsAntihypertensive Drugs and Their Cardioprotective and Renoprotective Roles in the Prevention and Management of Cardiovascular DiseaseJapan-Indonesia Collaborative Study of Imidapril on Antiproteinuric Effect in Hypertensive Patients with Chronic Kidney Disease (CKD)Effects of Calcium Channel Blockers on Proteinuria in Patients With Diabetic NephropathyHypertensionRenal Protection in Chronic Kidney DiseaseCalcium AntagonistsHypertension management in patients with diabetic nephropathyCalcium antagonistsWhat have we learned from the current trials?Impacto de los fármacos antihipertensivos sobre la enfermedad renalNephroprotective Effect of Bosentan in Diabetic RatsThe evolving role of diltiazem hydrochloride in cardiovascular managementUse of calcium antagonists in renal patients: Therapeutic benefit or medical malpractice?Pharmacologic management of diabetic nephropathyThe choice of antihypertensive drugs in patients with diabetes: Angiotensin II and beyondMicroalbuminuria Reduction With Valsartan in Patients With Type 2 Diabetes MellitusType 2 Diabetes: RENAAL and IDNT-The Emergence of New Treatment OptionsRenoprotective Effects of the Combination Trandolapril/Verapamil in Patients with Type 2 Diabetes Mellitus and HypertensionSlowing the Progression of Renal Disease in Diabetic PatientsEffect of nitrendipine and nisoldipine on renal structure and function in long-term experimental diabetes in ratsThe Irbesartan Type II Diabetic Nephropathy Trial: study design and baseline patient characteristicsLong-term effects of amlodipine versus fosinopril on microalbuminuria in elderly hypertensive patients with type 2 diabetes mellitusSelecting antihypertensive therapy in the pregnant woman with diabetes mellitusAntihypertensive Treatment in NIDDM, with Special Reference to Abnormal AlbuminuriaPhysician Knowledge and Practice Patterns Relating to Diabetic NephropathyTREATMENT WITH CARVEDILOL IS ASSOCIATED WITH A SIGNIFICANT REDUCTION IN MICROALBUMINURIA: A MULTICENTRE RANDOMISED STUDYRemission of nephrotic syndrome in type 1 diabetes: Long-term follow-up of patients in the Captopril StudyLacidipine reduces high blood pressure and the target organ damage induced by high fructose diet in ratsEffect of the calcium channel blocker nitrendipine in normotensive and spontaneously hypertensive, diabetic rats on kidney morphology and urinary albumin excretionClass differences in the effects of calcium channel blockers in the rat remnant kidney modelLacidipine Prevents the Hypertension and Renal and Cardiac Changes Induced by High-Fructose Diet in WKY RatsAntihypertensive treatment of patients with proteinuric renal diseases: Risks or benefits of calcium channel blockers?Diabetic nephropathyNephroprotective effect of antihypertensive drugs in essential hypertensionAntihypertensive Treatment in NIDDM, With Special Reference to Abnormal AlbuminuriaCalcium channel blockersCombined effects of an angiotensin converting enzyme inhibitor and a calcium antagonist on renal injuryShor- and long-term effect of a calcium channel blocker, barnidipine, on renal hemodynamics in spontaneously hypertensive, diabetic ratsMicroalbuminuria: A Marker to Increased Renal and Cardiovascular Risk in Diabetes MellitusRenal mortality associated with non-insulin-dependent diabetes mellitusEffects of benazepril and nicardipine on microalbuminuria in normotensive and hypertensive patients with diabetes*Therapeutic challenges in the obese diabetic patient with hypertensionCurrent Issues in Treating the Hypertensive Patient with Diabetes: Focus on Diabetic NephropathyThe diabetic patient with hypertensionSection Review; Cardiovascular & Renal: Calcium channel blockers for the treatment of renal diseaseDIABETIC NEPHROPATHY AND PREGNANCYComparative Study of the Effect of Ace Inhibitors and other Antihypertensive Agents on Proteinuria in Diabetic PatientsAntihypertensive Treatment in NIDDM, with Special Reference to Abnormal AlbuminuriaACE inhibitors and proteinuriaDiabetes Mellitus and Hypertension, Emerging Therapeutic PerspectivesDiltiazem: Ten Years of Clinical Experience in the Treatment of HypertensionHypertension in Diabetic Patients: An Update of Interventional Studies to Preserve Renal FunctionType II diabetic nephropathy in perspectiveNifedipine, but not verapamil, acutely elevates parathyroid hormone levels in premenopausal womenCalcium-Channel Entry Blocker Therapy for Hypertensive Patients with Concomitant Renal Impairment: A Focus on IsradipineLong-Term Treatment With Either Enalapril or Nitrendipine Stabilizes Albuminuria and Increases Glomerular Filtration Rate in Non- Insulin-Dependent Diabetic PatientsHypertension and Endstage Renal DiseaseAntihypertensive Treatment in NIDDM, with Special Reference to Abnormal AlbuminuriaAntihypertensive therapy with the calcium channel blocker isradipine: An appropriate choice for the diabetic patient with hypertensionThe cardiologist's approach to evaluation and management of the patient with essential hypertensionDetection and management of early diabetic nephropathyMaternal and Perinatal Implications of Diabetic NephropathyDiabetic nephropathyCalcium Antagonists and the Diabetic Hypertensive PatientNephroprotective Effects of Nitrendipine in Hypertensive Tune I and Type II Diabetic PatientsLong-term effects of antihypertensive regimens on renal hemodynamics and proteinuriaCaptopril or conventional therapy in hypertensive type II diabetics. Three-year analysis.Effect of diltiazem on glomerular heparan sulfate and albuminuria in diabetic rats.Renal Effects of Antihypertensive Medications: An OverviewIsolated rat glomerular cells demonstrate L-type Ca2+-channel activityHave Rational Therapeutic Principles Emerged in Treating Hypertension in Chronic Renal Failure?Diabetic nephropathyAngiotensin-Converting Enzyme Inhibitors in Diabetic NephropathyEfficacy of manidipine in the treatment of hypertension with renal impairment: A multicenter trialMaturity-onset diabetes and nephropathyA Comparison of Spirapril and Isradipine in Patients with Diabetic Nephropathy and HypertensionAntihypertensive Effect of Nitrendipine in the Hypertensive Patient with Renal ImpairmentHypertension and DiabetesFirst-line pharmacological treatment of hypertensionEffective treatment of hypertension in patients with diabetes mellitusThe evolution of antihypertensive therapy: Current theoretical conditions and individualized treatment optionsHypertensive nephropathy: Is a more physiologic approach to blood pressure control an important concern for the preservation of renal function?Adverse effect of the calcium channel blocker nitrendipine on nephrosclerosis in rats with renovascular hypertension.Diabetes mellitus and hypertension.Calcium antagonists for the treatment of systemic hypertensionNifedipine versus fosinopril in uninephrectomized diabetic ratsTreatment of arterial hypertension in diabetic humans: Importance of therapeutic selectionRisk for renal injury in diabetic hypertensive patientsAngiotensin converting enzyme inhibitors versus calcium antagonists in the treatment of diabetic hypertensive patients.β-adrenoceptor antagonists and antianginal drugsDiabetes and Hypertension: A ReviewHypertension and the KidneyCalcium-Channel Antagonists Reduce Renal Protein ExcretionRonald H. Lewis, MD 15 December 1990Volume 113, Issue 12Page: 987-988KeywordsAnimal modelsCalciumCapillariesDiabetes mellitusEpidermal growth factorExcretionHypertensionNephrologyProteinsProteinuria ePublished: 1 December 2008 Issue Published: 15 December 1990 PDF downloadLoading ...