Effect of Dilazep Dihydrochloride on Urinary Albumin Excretion in Patients with Autosomal Dominant Polycystic Kidney Disease

Abstract

Proteinuria and microalbuminuria occur with a highly variable severity and are associated with progression of autosomal dominant polycystic kidney disease (ADPKD). Dilazep dihydrochloride, an antiplatelet drug, is effective in patients with immunoglobulin A nephropathy or diabetic nephropathy. We studied whether dilazep dihydrochloride affects the urinary albumin excretion (UAE) in normotensive and hypertensive patients with ADPKD. Twelve normotensive ADPKD patients with microalbuminuria were randomly assigned to two groups: a dilazep (300 mg/day) treatment group (n = 6, group A) and a placebo group (n = 6, group B). In addition, 10 hypertensive ADPKD patients with microalbuminuria were randomly assigned to two groups: a dilazep (300 mg/day) treatment group (n = 5, group C) and a placebo group (n = 5, group D). Treatment with dilazep was continued for a period of 6 months, at the end of which the UAE was reduced form 130 ± 52 to 46 ± 26 µg/min (p < 0.01) in group A. There was no reduction in group C. There were no changes in UAE in placebo groups B and D. These results suggest that dilazep dihydrochloride may be effective in reducing UAE in normotensive ADPKD patients with microalbuminuria.

Silent cerebral infarction in patients with type 2 diabetic nephropathy. Effects of antiplatelet drug dilazep dihydrochloride

“…Although the mechanisms underlying the development and progression of diabetic nephropathy are not fully understood, platelet activation may participate by promoting microthrombus formation [21]. Recently, Yamagishi et al [22] reported that platelet activation plays a major role in the development and progression of rat diabetic nephropathy.…”

“…Numabe et al [23] reported that treatment with dilazep through vascular and nonvascular effects maintains brain function in animals susceptible to vascular injury and organ dysfunction. Dilazep dihydrochloride is commonly used in patients with IgA nephropathy, ischaemic heart disease, polycystic kidney disease or diabetic nephropathy [8,21,24,25], and it is known to cause an increase in cerebral blood flow [6]. Dilazep dihydrochloride is reported to show the suppression of platelet adhesion and coagulation, the suppression of the platelet phospholipase activity, and maintenance of glomerular filtration rate due to increased renal blood flow [8].…”

Antihypertensive treatments in adult autosomal dominant polycystic kidney disease: network meta-analysis of the randomized controlled trials

“…Ten RCTs with 1,386 participants were included after assessment of 45 full-text articles and 197 records [ 1 – 8 , 10 – 15 ]. Electronic searching process was shown in the flowchart (Figure 1 ).…”

“…The hypertension criteria in the studies was > 140/90 mm Hg. Two studies [ 6 , 15 ] divided patients into hypertension and normal BP groups.…”

Long-Term Effect of Imidapril Hydrochloride Compared With Dilazep Hydrochloride Administration on Blood Pressure and Renal Function in Patients With Chronic Glomerulonephritis

“…19) Yoshida, et al 20) analyzed the relation between a reduction in proteinuria and renal histological findings in 46 patients with IgA nephropathy administered dilazep. In 18 patients whose proteinuria was reduced by more than 25%, the degrees of glomerular sclerosis, crescent formation, mesangial matrix, and tubulo-interstitial lesions were milder compared with those who had a persistently high proteinuria.…”