PS 14-39 ROLE OF THE TRIPLE COMBINATION WITH INDAPAMIDE, NITRENDIPINE AND PERINDOPRIL IN RENAL PROTECTION

Abstract

Objective: To study of antihypertensive and renoprotective efficacy of indapamide, nitrendipine and perindopril combination therapy in hypertensive patients with low estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Design and Method: The study included 20 patients with II-III stage of essential hypertension (ESH/ESC 2013) and eGFR<60 ml/min/1.73 m2 in average age 60.17 ± 7.86 yrs. All patients were resistant to previously bi-component antihypertensive therapy. Blood pressure (BP) measured by Korotkov method. GFR estimated by MDRD formula. Levels of serum creatinine, uric acid and glucose were measured with biochemical assay method. All measurements performed before and after 24 weeks of triple combination, based on indapamide, perindopril and nitrendipine in average dose 2.15 ± 0.56 mg, 4.72 ± 1.79 mg and 12.77 ± 5.65 mg respectively. Results: During the 24 weekly antihypertensive therapy with three drug combination systolic BP decreased from 160.0 ± 15.81 to 127.3 ± 11.8 mmHg (p = 0.0001), and diastolic BP – from 98.94 ± 8.11 to 79.3 ± 6.24 mmHg (p = 0.0001). Serum creatinine level was significantly decrease from 110.59 ± 20.69 to 93.4 ± 19.67 μmol/L (p = 0.01). Plasma glucose and uric acid levels had tendency to decrease: from 5.77 ± 1.16 to 5.71 ± 1.56 mmol/L and from 6.36 ± 1.99 to 5.76 ± 1.78 mg/dL (p > 0.05) respectively. eGFR was improved during the 24 weekly treatment and increased from 51.04 ± 6.81 to 62.58 ± 13.12 ml/min/1.73 m2 (p = 0.003), eGFR elevated >60 ml/min/1.73 m2 in 50% cases. All patients finished 24-weekly therapy with good tolerability. Conclusions: 24-weekly therapy with indapamide, perindopril and nitrendipine were characterized with high antihypertensive efficacy and good tolerability. Three drugs combination also had shown renoprotective effects with significantly increase of eGFR in hypertensive patients.