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Антагонисты кальция и нефропротекция: современное положение и перспективы препарата нового поколения лерканидипина
Антагонисты кальция и нефропротекция: современное положение и перспективы препарата нового поколения лерканидипина
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Аннотация
В статье представлен обзор нефропротективных свойств антагонистов кальция (АК), которые относятся к антигипертензивным препаратам первой линии. В настоящее время роль АК в терапии больных с хроническими заболеваниями почек до конца не определена, а полученная в клинических исследованиях информация об их ренопротективном действии достаточно противоречива. В обзоре показано, что влияние АК на функцию почек варьирует в зависимости от типа АК (дигидропиридиновый и недигидропиридиновый). Представлены гемо- и негемодинамические механизмы нефропротективного влияния АК. Обращается внимание на рациональное сочетание АК с блокаторами ренин-ангиотензин-альдостероновой системы. Описаны отличительные от «классических» АК особенности нефропротективного действия нового представителя АК – препарата лерканидипина и обозначены перспективы его применения в клинической практике.
Ключевые слова: антагонисты кальция, артериальная гипертония, нефропротекция, лерканидипин.
Key words: calcium antagonists, arterial hypertension, nephroprotection, lercanidipine.
Ключевые слова: антагонисты кальция, артериальная гипертония, нефропротекция, лерканидипин.
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Key words: calcium antagonists, arterial hypertension, nephroprotection, lercanidipine.
Полный текст
Список литературы
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8. Robles NR. Calcium Antagonists and renal failure: new properties for new generations. Med Hypotheses Res 2006; 3: 709–25.
9. Borghi C. Lercanidipine in hypertension. Vascular Health and Risk Management 2005; 1 (3): 173–82.
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13. Kon V, Fogo A and Ichikawa I. Bradykinin causes selective efferent arteriolar dilation during angiotensin I converting enzyme inhibition. Kidney Int 1993; 44: 545–50.
14. Ichikawa I. Will angiotensin II receptor antagonists be renoprotective in humans? Kidney Int 1996; 50: 684–92.
15. Sabbatini M, Leonardi A, Testa R et al. Effect of Calcium Antagonists on Glomerular Arterioles in Spontaneously Hypertensive Rats. Hypertension 2000; 35: 775–9.
16. Sugiura T, Imai E, Moriyama T et al. Calcium channel blockers inhibit proliferation and matrix production in rat mesangial cells: Possible mechanism of suppression of AP-1 and CREB activities. Nephron 2000; 85: 71–80.
17. Roth M, Keul R, Emmons LR et al. Manidipine regulates the transcription of cytokine genes. Proc Natl Acad Sci USA 1992; 89: 4071–5.
18. Hayashi M, Yamaji Y, Nakazato Y, Saruta T. The effects of calcium channel blockers on nuclear factor kappa B activation in the mesangial cells. Hypertens Res 2000; 23: 521–5.
19. Epstein M. Calcium antagonists and renal protection: emerging perspectives. J Hypertens 1998; 18 (Suppl. 4): S17–S25.
20. Carmines PK, Navar LG. Disparate effects of Ca channel blockers on afferent and efferent arteriolar responses to ANG II. Am J Physiol 1989; 256: F1015–F20.
21. Loutzenhiser R, Epstein M. Renal hemodynamic effects of calcium antagonists. In: Epstein M and Loutzenhiser R (EDITORS). Calcium Antagonists and the Kidney. Philadelphia. Hanley & Belfus 1990: 33–74.
22. Fleming JT, Parekh N, Steinhausen M. Calcium antagonists preferentially dilate preglomerular vessels of hydronephrotic kidney. Am J Physiol 1987; 253: F1157–F63.
23. Arima S, Ito S, Omata K et al. Diverse effects of calcium antagonists on glomerular hemodynamics. Kidney Int 1996; 55 (Suppl.): S132–S4.
24. Hayashi K, Ozawa Y, Fujiwara K et al. Role of actions of calcium antagonists on efferent arterioles – with special references to glomerular hypertension. Am J Nephrol 2003; 23: 229–44.
25. Dworkin LD, Tolbert E, Recht PA et al. Effects of amlodipine on glomerular filtration, growth, and injury in experimental hypertension. Hypertension 1996; 27: 245–50.
26. Harris DC, Hammond WS, Burke TJ, Schrier RW. Verapamil protects against progression of experimental chronic renal disease. Kidney Int 1987; 31: 41–6.
27. Dworkin LD, Feiner HD, Parker M, Tolbert E. Effects of nifedipine and enalapril on glomerular structure and function in uninephrectomized SHR. Kidney Int 1991; 9: 1112–7.
28. Wenzel UO, Troschau G, Schoeppe W et al. Adverse effect of the calcium channel blocker nitrendipine on nephrosclerosis in rats with renovascular hypertension. Hypertension 1992; 20: 233–41.
29. Bakris GL, Mangrum A, Copley JB et al. Effect of Calcium Channel or β-Blockade on the Progression of Diabetic Nephropathy in African Americans. Hypertension 1997; 29: 744–50.
30. THE PROCOPA STUDY GROUP. Dissociation between blood pressure reduction and fall in proteinuria in primary renal disease: A randomized doubleblind trial. J Hypertension 2002; 20: 729–37.
31. Voyaki SM, Staessen JA, Thijs L et al. Systolic Hypertension in Europe (SYST-EUR) Trial Investigators. Follow-up of renal function in treated and untreated older patients with isolated systolic hypertension. J Hypertens 2001; 19: 511–9.
32. National Intervention Cooperative Study in Elderly Hypertensives. Randomized double-blind comparison of a calcium antagonist and a diuretic in elderly hypertensives. Hypertension 1999; 34: 1129–33.
33. Brown MJ, Palmer CR, Castaigne A et al. Morbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet 2000; 356: 366–72.
34. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihyperten-sive and Lipid Lowering treatment to prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981–97.
35. Baba S and J-MIND Study Group. Nifedipine and enalapril equally reduce the progression of nephropathy in hypertensive Type 2 diabetics. Diabetes Res Clin Pract 2001; 54: 191–201.
36. Marin R, Ruilope LM, Aljama P et al. A random comparison of fosinopril and nifedipine GITS in patients with primary renal disease. J Hypertens 2001; 19: 1871–6.
37. Fogari R, Preti P, Zoppi A et al. Effects of amlodipine fosinopril combination on microalbumnuria in hypertensive Type 2 diabetic patients. Am J Hypertens 2002; 15: 1042–9.
38. Shigihara T, Sato A, Hayashi K, Saruta T. Effect of combination therapy of angiotensin-converting enzyme inhibitor plus calcium channel blocker on urinary albumin excretion in hypertensive microalbuminuric patients with Type II diabetes. Hypertens Res 2000; 23: 219–26.
39. Ruggenenti P, Perna A, Loriga G et al. The REIN-2 Study Group. Blood pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): Multicentre, randomised controlled trial. Lancet 2005; 365: 939–46.
40. Yokoyama S and Kaburagi T. Clinical effects of intravenous nifedipine on renal function. J Cardiovasc Pharmacol 1983; 5: 67–71.
41. Wallia R, Greenberg A and Puschett JB. Renal hemodynamic and tubular transport effects of nitrendipine. J Lab Clin Med 1985; 105: 498–503.
42. Ozawa Y, Hayashi K, Oka K et al. Divergent action of calcium antago-nists on the efferent arteriole (abstract). J Hypertens 1998; 16 (Suppl. 2): S27.
43. Hansen PB, Jensen BL, Andreasen D, Skøtt O. Differential expression of T- and L-type voltage-dependent calcium channels in renal resistance vessels. Circ Res 2001; 89: 630–38.
44. Takakura S, Furuichi Y, Yamamoto T et al. Effects of nilvadipine on the development of neurological deficits in stroke-prone spontaneously hypertensive rats. Stroke 1994; 25: 677–82.
45. Shudo C, Masuda Y, Sugita H et al. Effects of efonidipine, nicardipine and captopril on proteinuria in aged spontaneously hypertensive rats. Arzneimittel-Forsch 1996; 46: 852–4.
46. Fujimaki M, Nagase M and Uchida S. Long-term effect of manidipine on renal function and structure in uninephrectomized spontaneously hypertensive rats. Clin Exp Pharmacol Physiol 1997; 24: 506–12.
47. Vestra MD, Pozza G, Vosca A et al. Effect of lercanidipine compared with ramipril on albumin rate in hypertensive Type 2 diabetic with microalbuminuria: DIAL Study (Diabete, Ipertensione, Albuminuria, Lercanidipina). Diab Nutr Metab 2004; 17: 259–66.
48. Hayashi K, Ozawa Y, Fujiwara K et al. Role of actions of calcium antagonists on efferent arterioles – with special references to glomerular hypertension. Am J Nephrol 2003; 23: 229–44.
49. Robles NR, Ocon J, Gomez Campderá F et al. Lercanidipine in chronic renal failure patients: The ZAFRA Study. Renal Failure 2005; 27: 73–80.
2. Brown MJ, Palmer CR, Castaigne A et al. Morbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet 2000; 356: 366–72.
3. The ALLHAT officers and coordinators for the ALLHAT Collaborative research group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981–97.
4. Pepine CJ, Handberg EM, Cooper-Dehoff RM et al. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil–Trandolapril Study (INVEST), a randomized controlled trial. JAMA 2003; 290: 2805–16.
5. Julius S, Kjeldsen SE, Weber M et al. Outcomes in hypertensive patients at high cardiovascular risk treated with valsartan – or amlodipine – based regimens: VALUE, a randomised trial. Lancet 2004; 363: 366–72.
6. Dalhöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendrofluazide as required, in Anglo-Scandinavian Cardiac Outcome Trial Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005; 366: 895–906.
7. Hansson L, Hedner T, Lund-Johansen P et al. Randomised trial of effects of calcium antagonists compared with diuretics and β-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 2000; 356: 359–65.
8. Robles NR. Calcium Antagonists and renal failure: new properties for new generations. Med Hypotheses Res 2006; 3: 709–25.
9. Borghi C. Lercanidipine in hypertension. Vascular Health and Risk Management 2005; 1 (3): 173–82.
10. Klag MJ, Whelton PK, Randall BL et al. Blood pressure and end-stage renal disease in men. N Engl J Med 1996; 334: 13–8.
11. Herbette LG, Gaviraghi G, Tulenko T, Mason RP. Molecular interaction between lacidipine and biological membranes. J Hypertens 1993; Suppl. 11: S13–19.
12. Reams GP, Bauer JH. Acute and chronic effects of calcium antagonists on the essential hypertensive kidney. In: Epstein M. and Loutzenhiser R. (EDITORS), Calcium Antagonists and the Kidney. Philadelphia. Hanley & Belfus 1990: 247–56.
13. Kon V, Fogo A and Ichikawa I. Bradykinin causes selective efferent arteriolar dilation during angiotensin I converting enzyme inhibition. Kidney Int 1993; 44: 545–50.
14. Ichikawa I. Will angiotensin II receptor antagonists be renoprotective in humans? Kidney Int 1996; 50: 684–92.
15. Sabbatini M, Leonardi A, Testa R et al. Effect of Calcium Antagonists on Glomerular Arterioles in Spontaneously Hypertensive Rats. Hypertension 2000; 35: 775–9.
16. Sugiura T, Imai E, Moriyama T et al. Calcium channel blockers inhibit proliferation and matrix production in rat mesangial cells: Possible mechanism of suppression of AP-1 and CREB activities. Nephron 2000; 85: 71–80.
17. Roth M, Keul R, Emmons LR et al. Manidipine regulates the transcription of cytokine genes. Proc Natl Acad Sci USA 1992; 89: 4071–5.
18. Hayashi M, Yamaji Y, Nakazato Y, Saruta T. The effects of calcium channel blockers on nuclear factor kappa B activation in the mesangial cells. Hypertens Res 2000; 23: 521–5.
19. Epstein M. Calcium antagonists and renal protection: emerging perspectives. J Hypertens 1998; 18 (Suppl. 4): S17–S25.
20. Carmines PK, Navar LG. Disparate effects of Ca channel blockers on afferent and efferent arteriolar responses to ANG II. Am J Physiol 1989; 256: F1015–F20.
21. Loutzenhiser R, Epstein M. Renal hemodynamic effects of calcium antagonists. In: Epstein M and Loutzenhiser R (EDITORS). Calcium Antagonists and the Kidney. Philadelphia. Hanley & Belfus 1990: 33–74.
22. Fleming JT, Parekh N, Steinhausen M. Calcium antagonists preferentially dilate preglomerular vessels of hydronephrotic kidney. Am J Physiol 1987; 253: F1157–F63.
23. Arima S, Ito S, Omata K et al. Diverse effects of calcium antagonists on glomerular hemodynamics. Kidney Int 1996; 55 (Suppl.): S132–S4.
24. Hayashi K, Ozawa Y, Fujiwara K et al. Role of actions of calcium antagonists on efferent arterioles – with special references to glomerular hypertension. Am J Nephrol 2003; 23: 229–44.
25. Dworkin LD, Tolbert E, Recht PA et al. Effects of amlodipine on glomerular filtration, growth, and injury in experimental hypertension. Hypertension 1996; 27: 245–50.
26. Harris DC, Hammond WS, Burke TJ, Schrier RW. Verapamil protects against progression of experimental chronic renal disease. Kidney Int 1987; 31: 41–6.
27. Dworkin LD, Feiner HD, Parker M, Tolbert E. Effects of nifedipine and enalapril on glomerular structure and function in uninephrectomized SHR. Kidney Int 1991; 9: 1112–7.
28. Wenzel UO, Troschau G, Schoeppe W et al. Adverse effect of the calcium channel blocker nitrendipine on nephrosclerosis in rats with renovascular hypertension. Hypertension 1992; 20: 233–41.
29. Bakris GL, Mangrum A, Copley JB et al. Effect of Calcium Channel or β-Blockade on the Progression of Diabetic Nephropathy in African Americans. Hypertension 1997; 29: 744–50.
30. THE PROCOPA STUDY GROUP. Dissociation between blood pressure reduction and fall in proteinuria in primary renal disease: A randomized doubleblind trial. J Hypertension 2002; 20: 729–37.
31. Voyaki SM, Staessen JA, Thijs L et al. Systolic Hypertension in Europe (SYST-EUR) Trial Investigators. Follow-up of renal function in treated and untreated older patients with isolated systolic hypertension. J Hypertens 2001; 19: 511–9.
32. National Intervention Cooperative Study in Elderly Hypertensives. Randomized double-blind comparison of a calcium antagonist and a diuretic in elderly hypertensives. Hypertension 1999; 34: 1129–33.
33. Brown MJ, Palmer CR, Castaigne A et al. Morbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet 2000; 356: 366–72.
34. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihyperten-sive and Lipid Lowering treatment to prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981–97.
35. Baba S and J-MIND Study Group. Nifedipine and enalapril equally reduce the progression of nephropathy in hypertensive Type 2 diabetics. Diabetes Res Clin Pract 2001; 54: 191–201.
36. Marin R, Ruilope LM, Aljama P et al. A random comparison of fosinopril and nifedipine GITS in patients with primary renal disease. J Hypertens 2001; 19: 1871–6.
37. Fogari R, Preti P, Zoppi A et al. Effects of amlodipine fosinopril combination on microalbumnuria in hypertensive Type 2 diabetic patients. Am J Hypertens 2002; 15: 1042–9.
38. Shigihara T, Sato A, Hayashi K, Saruta T. Effect of combination therapy of angiotensin-converting enzyme inhibitor plus calcium channel blocker on urinary albumin excretion in hypertensive microalbuminuric patients with Type II diabetes. Hypertens Res 2000; 23: 219–26.
39. Ruggenenti P, Perna A, Loriga G et al. The REIN-2 Study Group. Blood pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): Multicentre, randomised controlled trial. Lancet 2005; 365: 939–46.
40. Yokoyama S and Kaburagi T. Clinical effects of intravenous nifedipine on renal function. J Cardiovasc Pharmacol 1983; 5: 67–71.
41. Wallia R, Greenberg A and Puschett JB. Renal hemodynamic and tubular transport effects of nitrendipine. J Lab Clin Med 1985; 105: 498–503.
42. Ozawa Y, Hayashi K, Oka K et al. Divergent action of calcium antago-nists on the efferent arteriole (abstract). J Hypertens 1998; 16 (Suppl. 2): S27.
43. Hansen PB, Jensen BL, Andreasen D, Skøtt O. Differential expression of T- and L-type voltage-dependent calcium channels in renal resistance vessels. Circ Res 2001; 89: 630–38.
44. Takakura S, Furuichi Y, Yamamoto T et al. Effects of nilvadipine on the development of neurological deficits in stroke-prone spontaneously hypertensive rats. Stroke 1994; 25: 677–82.
45. Shudo C, Masuda Y, Sugita H et al. Effects of efonidipine, nicardipine and captopril on proteinuria in aged spontaneously hypertensive rats. Arzneimittel-Forsch 1996; 46: 852–4.
46. Fujimaki M, Nagase M and Uchida S. Long-term effect of manidipine on renal function and structure in uninephrectomized spontaneously hypertensive rats. Clin Exp Pharmacol Physiol 1997; 24: 506–12.
47. Vestra MD, Pozza G, Vosca A et al. Effect of lercanidipine compared with ramipril on albumin rate in hypertensive Type 2 diabetic with microalbuminuria: DIAL Study (Diabete, Ipertensione, Albuminuria, Lercanidipina). Diab Nutr Metab 2004; 17: 259–66.
48. Hayashi K, Ozawa Y, Fujiwara K et al. Role of actions of calcium antagonists on efferent arterioles – with special references to glomerular hypertension. Am J Nephrol 2003; 23: 229–44.
49. Robles NR, Ocon J, Gomez Campderá F et al. Lercanidipine in chronic renal failure patients: The ZAFRA Study. Renal Failure 2005; 27: 73–80.
Авторы
М.Г.Бубнова
ФГУ Государственный научно-исследовательский Центр профилактической медицины Минздравсоцразвития РФ, Москва
mbubnova@gnicPM.ru
State Research Center for Preventive Medicine, Ministry of Health and Social Development of the RF, Moscow
mbubnova@gnicPM.ru
ФГУ Государственный научно-исследовательский Центр профилактической медицины Минздравсоцразвития РФ, Москва
mbubnova@gnicPM.ru
________________________________________________
State Research Center for Preventive Medicine, Ministry of Health and Social Development of the RF, Moscow
mbubnova@gnicPM.ru
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