RENAL EFFECTS OF PROLONGED ANTIHYPERTENSIVE TREATMENT WITH DILTIAZEM

The effects of diltiazem (DTZ) treatment on blood pressure, renal func tion and renal hemodynamics over a six week period of therapy were eva luated in 14 adult patients with mild to moderate hypertension. Their creatinine clearances were 64 to 153 ml/min. After a week of treatment with placebo, DTZ was administered orally at a daily dose of 170 mg b .i.d. Blood pressure decreased from a mean value of 152/99 mm Hg (+/- 13/6 SD) up to 144/91 (+/- 17/8, P < 0.005) in the supine position and from 149/107 (+/- 14/9) to 141/96 (+/- 16/9, P < 0.005) in standing p osition. Heart rate decreased from 74 (+/- 9) to 69 (+/- 8). Plasma ur ea, creatinine, uric acid and their clearances as well as GFR and ERPF remained stable throughout the trial. Plasma glucose increased from 8 1 (+/- 15) mg/dl to 98 (+/- 30, P < 0.05) and plasma potassium decreas ed from 4.0 mEq/liter to 3.7 (+/- 0.3, P < 0.005). Plasma cholesterol and triglycerides were unmodified. DTZ is an effective antihypertensiv e agent which does not significantly affect renal function. The effect s on plasma glucose and potassium require periodical check-ups of thes e parameters.