Cilnidipine effectively reduces low-grade albuminuria in hypertensive chronic kidney disease patients

Abstract

BackgroundMicroalbuminuria, defined as urine albumin to urine creatinine ratio of 30 to <300mg/g, is an established risk factor for cardiovascular morbidity and mortality in the general population. Low-grade albuminuria (<30mg/g) is considered a marker for subclinical vascular damage that predisposes to future cardiovascular diseases and death. Lowering urinary albumin excretion reduces the risk of cardiovascular disease. Our study was designed to evaluate the influence of novel calcium channel blocker, cilnidipine in hypertensive chronic kidney disease (CKD) patients with lowgrade albuminuria. Patients and methodsOur 6-month prospective observation study used a randomized control and open-label design as we examined the effects of cinidipine on blood pressure, urinary albumin excretion and estimated glomerular filtration rate (eGFR) in hypertensive CKD patients. A total of 60 hypertensive CKD patients were enrolled in this study. Patients were randomly assigned to 2 groups: cilnidipine group (n=30), receiving 10–20mg cilnidipine daily for 6 months, and the control group (n=30). ResultsIn the cilnidipine group, urine albumin excretion was significantly reduced from 25.1±19.9mg/g Cr at baseline to 12.6±9.0mg/g Cr at 6 months after administration. eGFR decreased slightly at 6 months after administration. ConclusionsThis study reveals that cilnidipine is safe and effective in reducing low-grade albuminuria in hypertensive CKD patients. Thus, early treatment of cilnidipine in hypertensive CKD patients with low-grade albuminuria may prevent cardiovascular disease.