CALCIUM-ANTAGONISTS AND RENAL PROTECTION - EMERGING PERSPECTIVES

During the past two decades, major investigative interest has focused on the determinants of chronic renal disease and interventions that re tard the inexorable progression to end-stage renal disease, Recent stu dies have provided a theoretic framework for anticipating that angiote nsin-converting enzyme (ACE) inhibitors, and possibly calcium antagoni sts, may preferentially retard the progression of renal disease. Where as the majority of available clinical trials have assessed the effects of ACE inhibitors in patients with insulin-dependent diabetes mellitu s, relatively few longterm studies have evaluated the renoprotective e ffects of ACE inhibitors and calcium antagonists in patients with nond iabetic renal disease. Recent observations suggest that the two classe s of drugs act in a complementary manner to countervail pathogenetic m echanisms at the level of the mesangium. Such observations recently pr ompted randomized prospective studies that compare the renoprotective effects of calcium antagonist versus ACE inhibitor monotherapy in both diabetic patients and patients with nondiabetic renal disease. J Hype rtens 16 (suppl 4):S17-S25 (C) 1998 Lippincott Williams & Wilkins