A13716 Impacts of cilnidipine on blood pressure elevation during hemodialysis in patients with intradialytic hypertension

Abstract

Objectives: Intradialytic hypertension (HTN) is one of the poor prognostic markers and may be associated with sympathetic overactivity. L/N-type calcium channel blocker cilnidipine was reported to suppress sympathetic nerves activity and lower blood pressure (BP). Methods: Fifty-one patients with end-stage renal disease on chronic hemodialysis who had intradialytic HTN (systolic BP elevation > 10 mmHg during hemodialysis) and no fluid overload were randomized into 2 groups: control and cilnidipine groups. Patients in cilnidipine group took cilnidipine (10 mg/day) for 12 weeks. The primary endpoint was the change in intradialytic systolic BP elevation before and after the 12 weeks of the intervention. Results: Before the intervention, no differences were observed in age, gender or pre-dialytic systolic BP (148.5 ± 12.9 vs. 148.3 ± 19.3 mmHg) between the 2 groups. Intradialytic systolic BP elevation was unchanged in control group. Cilnidipine significantly lowered post-dialytic systolic BP and thus appeared to attenuate intradialytic SBP elevation from 12.0 ± 15.4 mmHg to 4.8 ± 10.1 mmHg. However, this observed difference in intradialytic systolic BP elevation by cilnidipine did not reach a statistical significance. Catecholamine was unaffected in either group. Conclusion: Although cilnidipine failed to attenuate intradialytic systolic BP elevation in patients with intradialytic HTN, cilnidipine decreased both pre- and post-dialytic BP. Therefore, cilnidipine may be effective to lower systolic BP during HD in patients with intradialytic HTN.