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  1. Vellanki, Venkat Sai Naresh
  2. General Nephrology Questions
  3. Sunday, 20 April 2014
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Hi! Dr Weinstein

The focus seems to be dihydropyridine calcium channel antagonists + ACEI/ARB based practice in routine redressal of hypertension and proteinuria reduction, we hardly see any use of novel L/N type Ca channel antagonist Clinidipine despite its existence for a while now, Japanese Nephrology and hypertension community seem to be very positive on its role on hypertension and proteinuria reduction in diabetics and a favorable cardiac remodeling in CKD cohorts consistently.

1) Clin Exp Nephrol. 2013 Feb;17(1):41-50
2) Int J Mol Sci. 2013 Aug 16;14(8)
3) Kidney Int. 2007 Dec;72(12):1543-9 --CARTER STUDY

best

Venkat Vellanki
  Toronto, ON, Canada
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Responses (1)
Accepted Answer Pending Moderation
Hi Venkat,

I am not familiar with this drug and to my knowledge is not available in Canada (where I practice).

However, dihydropyridine calcium channel antagonists do not have a good track record from the point of view of proteinuria,, though are excellent blood pressure drugs. In fact the most striking finding to me of the ACCOMPLISH study (linked below) was that patients on HCTZ had much lower proteinuria levels on treatment compared to those receiving amlodipine. What's even more interesting is that patients on amlodipine did better from the point of view of cardiovascular outcomes despite worsening proteinuria.

But I will review the data you suggested above.

Dr. Jordan Weinstein
References
  1. http://www.nejm.org/doi/full/10.1056/NEJMoa0806182
  1. more than a month ago
  2. General Nephrology Questions
  3. # 1
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