Use of Calcium Channel Blockers is Associated with Mortality in Patients with Chronic Kidney Disease

Abstract

Background/Aims: The use of antihypertensive medicines has been shown to reduce proteinuria, morbidity, and mortality in patients with chronic kidney disease (CKD). A specific recommendation for a class of antihypertensive drugs is not available in this population, despite the pharmacodynamic differences. We have therefore analysed the association between antihypertensive medicines and survival of patients with chronic kidney disease. Methods: Out of 2687 consecutive patients undergoing kidney biopsy a cohort of 606 subjects with retrievable medical therapy was included into the analysis. Kidney function was assessed by glomerular filtration rate (GFR) estimation at the time point of kidney biopsy. Main outcome variable was death. Results: Overall 114 (18.7%) patients died. In univariate regression analysis the use of alpha-blockers and calcium channel antagonists, progression of disease, diabetes mellitus (DM) type 1 and 2, arterial hypertension, coronary heart disease, peripheral vascular disease, male sex and age were associated with mortality (all p<0.05). In a multivariate Cox regression model the use of calcium channel blockers (HR 1.89), age (HR 1.04), DM type 1 (HR 8.43) and DM type 2 (HR 2.17) and chronic obstructive pulmonary disease (HR 1.66) were associated with mortality (all p < 0.05). Conclusion: The use of calcium channel blockers but not of other antihypertensive medicines is associated with mortality in primarily GN patients with CKD.

Microarray Analysis Reveals Increased Expression of Matrix Metalloproteases and Cytokines of Interleukin-20 Subfamily in the Kidneys of Neonate Rats Underwent Unilateral Ureteral Obstruction: A Potential Role of IL-24 in the Regulation of Inflammation and Tissue Remodeling

“…While mild stenosis do not lead to serious clinical consequences sever urinary tract obstruction results in CON [21, 22]. The high morbidity and mortality rate of pediatric patients with CON and the limitations of currently available treatment options emphasize the need to better understand the underlying mechanisms [23]. In the present study we used a neonatal rat model of complete UUO.…”

Perbandingan Efektivitas Angiotensin Receptor Blocker (ARB) dengan Calcium Channel Blocker (CCB) Pada Pasien Penyakit Ginjal Kronis dengan Hemodialisis

“…Penggunaan ARB memberikan manfaat proteksi kardiovaskular pada pasien PGK (Xie et al, 2016) sedangkan penggunaan CCB dikaitkan dengan mortalitas pada pasien PGK dimana hal ini seperti yang dilaporkan studi-studi sebelumnya yang menyatakan peningkatan risiko kejadian kardiovaskular dengan penggunaan antagonis kalsium (Haider et al, 2015).…”

The roles of sodium and volume overload on hypertension in chronic kidney disease

“…As the second-line drug, the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend diuretics [ 32 ], but ESH-ESC (European Society of Hypertension/European Society of Cardiology) 2018 guidelines advocated for calcium channel blockers (CCB) [ 41 ]. As for CCB, it was reported to be associated with mortality in CKD patients with glomerulonephritis [ 42 ]. But in a meta-analysis, CCB has similar effects to RASB in terms of long-term BP, mortality, heart failure, stroke or cerebrovascular events, and renal function [ 43 ].…”