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Hypertensive Patients With Renal Impairment Have Fewer Side Effects From Efonidipine

Hypertensive patients with renal impairment can benefit from both efonidipine and ACE inhibitors, both of which preserve renal impairment, although efonidipine has fewer side effects.

The dilatory action on both afferent and efferent arterioles of dihydropyridine efonidipine possesses the same renal microvascular action as angiotensin converting enzyme (ACE) inhibitors. Following a previous report that it had displayed renal protection in animals, researchers from Tokyo's Keio University, Japan, evaluated the effect of both therapeutic agents on blood pressure (BP) and proteinuria in humans.

They randomly assigned efonidipine or ACE inhibitors to patients who had either renal impairment or chronic renal parenchymal disease. Twenty-three patients were prescribed efonidipine, 20 received ACE inhibitors and then underwent analysis for a 48-week study.

A similar degree of BP reduction and maintained creatinine clearance was noted in both agents during the 48 weeks. Both groups revealed a tendency to decrease proteinuria, with a significant reduction seen in proteinuric patients.

Proteinuria was decreased by efonidipine in proteinuric patients who had failed to show decreases in systemic BP but the proteinuric effect was clearly shown in patients who had greater proteinuria.

Researchers also concluded that there were fewer incidences of adverse effects such as hyperkalemia and cough in the efonidipine-treated patients.
American Journal of Hypertension 2003;16:2:116-22. "Effect of efonidipine and ACE inhibitors on proteinuria in human hypertension with renal impairment."

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