ANTIHYPERTENSIVE EFFECT OF NITRENDIPINE IN THE HYPERTENSIVE PATIENT WITH RENAL IMPAIRMENT

Calcium antagonists exert several characteristic effects on the kidney that potentiate their antihypertensive effect. The objective of the p resent study was to investigate the effectiveness of nitrendipine in t he presence of different degrees of renal impairment. Two groups of hy pertensive patients were included in the study. Group 1: 10 patients w ith arterial hypertension secondary to chronic renal parenchymatous di sease and adequately controlled with a diuretic and/or a beta-blocker who were switched to nitrendipine. These patients were then followed m onthly for 1 year. Group 2: 24 patients diagnosed as having essential hypertension who presented values of urinary albumin excretion above 3 0 mg/day after a minimum of 3 years of adequate blood pressure control with a diuretic and/or a beta-blocker. Patients were randomly assigne d to continue with the same therapy or to switch to nitrendipine for 1 year. In both groups nitrendipine was as efficacious as standard ther apy for controlling blood pressure and did not induce changes in renal hemodynamics. Nitrendipine did not modify the level of proteinuria in group 1, nor the urinary excretion of albumin in group 2. These resul ts seem to indicate that nitrendipine can be safely used in patients w ith arterial hypertension and different degrees of renal function impa irment.