Effect of nicorandil on proteinuria in well controlled hypertensive patients

Abstract

The addition of nicorandil to treatment for patients with well controlled hypertension may have an additive effect on reducing proteinuria independent of hemodynamics and nitric oxide effects, possibly through inhibiting renal endothelin-1 synthesis and improving tubular function.

Nicorandil, a Katp channel opener, alleviates chronic renal injury by targeting podocytes and macrophages

“…This finding is consistent with the prior experimental studies (17,19), as well as a recent report that nicorandil could reduce proteinuria in hypertensive subjects (8). Our laboratory has recently reported that nicorandil potently reduced urinary albumin excretion in diabetic endothelial NO synthase-deficient mice (20).…”

Nicorandil Improves Glomerular Injury in Rats With Mesangioproliferative Glomerulonephritis via Inhibition of Proproliferative and Profibrotic Growth Factors

“…Accordingly, we expect that the inhibitory effects of nicorandil on proteinuria may reduce the risk for CVD, such as heart failure, in patients with renal dysfunction. Most recently, it was reported that addition of nicorandil to treatment for hypertensive patients who were well controlled by a low dose of angiotensin receptor blocker, valsartan, significantly reduced proteinuria without affecting blood pressure (28). In the future, we hope clinical studies will demonstrate that nicorandil has therapeutic usefulness for the treatment of cardio-renal syndromes.…”

Nicorandil Ameliorated Hypertensive Renal Injury without Lowering Blood Pressure in Spontaneously Hypertensive Rats

“…Moreover, Gross et al [49] suggested that despite marked expression of ET-1 and ET receptors, blockade of ETA receptors was far less effective than ACE inhibition in attenuating glomerular and tubulointerstitial lesions in a rat model of metabolic syndrome. Recently, Lee and Chang [50] demonstrated a clinical effect of nicorandil whereby the addition of nicorandil to treatment for patients with well-controlled hypertension may have an additive effect on reducing proteinuria independent of hemodynamics and nitric oxide effects, possibly through inhibiting renal ET-1 synthesis and improving tubular function. The reason behind the discrepancy in results between the study by Lee and Chang [50] in hypertensive patients and our present analysis was not clear; however, species difference might be responsible.…”

“…Recently, Lee and Chang [50] demonstrated a clinical effect of nicorandil whereby the addition of nicorandil to treatment for patients with well-controlled hypertension may have an additive effect on reducing proteinuria independent of hemodynamics and nitric oxide effects, possibly through inhibiting renal ET-1 synthesis and improving tubular function. The reason behind the discrepancy in results between the study by Lee and Chang [50] in hypertensive patients and our present analysis was not clear; however, species difference might be responsible. The role of endothelin within the mechanism of hypertensive nephropathy in SHR remains to be resolved, and further study is necessary.…”