LERCANIDIPINE IN CHRONIC RENAL FAILURE (CRF)

N.R. Robles¹, J. Ocon², F. Gomez-Campdera³, L. Pastor⁴, J. Herrera⁵, J. Vilatoro⁶

¹ Hosp. Infanta Cristina, Badajoz, ² Fundacion Puigvert, Barcelona, ³ Hosp. Gregorio Marañon, Madrid, ⁴ Hosp. Miguel Servet, Zaragoza, ⁵ Hosp. Gral. Asturias, Oviedo; ⁶ Hosp. de Castellon, Castellon de la Plana, Spain

Objective: To evaluate the safety use of a new calcium channel blocker, lercanidipine, in CRF patients. Furthermore, to study the protective effect of calcium channel blocker on renal function in CRF patients treated with ACE inhibitors.

Design and Methods: The study recruited 203 CRF patients (creatinine >1.4 mg/dl for males, creatinine >1.2 mg/dl for females, or creatinine clearance <70 ml/min). All patients were receiving ACE inhibitors (63.4%) or angiotensin II antagonist (36.6%) therapy but they had higher blood pressure than recommended for CRF (130/85 mmHg). No patients were under diuretic treatment. Patients were clinically evaluated 1, 3 and 6 moths after starting treatment with lercanidipine. Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to treatment, excluding diuretics. Creatinin clearance was measured using 24 h urine collection.

Results: 175 patients rendered evaluable for the study (age 63.9 ±11.9 years, 52.9% males and 47.1 females). BP significantly decrease from 16217/938.3 mmHg to 13212/786 mmHg. 89.2% patients showed a significant BP reduction and 58.1% gets optimal BP control (<130/85 mmHg). Seven patients (3.4%) showed untoward effects. No one case of oedema was detected and the prevalence of adverse effects related to vasodilatation was extremely low (3 patients, 1.48%). Plasmatic creatinin did not change (1.90.5 baseline vs 1.90.6 mg/dl) but creatinine clearance increased at the end visit (41.816.0 baseline vs 45.818.0 ml/min, p = 0.019). Plasmatic cholesterol also decreased from 22146 to 21135 mg/dl (p = 0.001).

Conclusions: Lercanidipine showed a high antihypertensive effect in CRF patients. It has a good tolerability profile and showed an interesting effect on plasmatic lipids. An improvement in renal function, measured through creatine clearance, was detected.