Renal functional reserve in calcium channel blocker-treated hypertensive recipients of kidney transplant

Nephrol Dial Transplant. 1995:10 Suppl 6:117-9. doi: 10.1093/ndt/10.supp6.117.

Abstract

Renal functional reserve during infusion of an amino acid solution was examined in 12 cyclosporin-treated kidney recipients at 1 (T1) and 8 months (T2) after transplantation. Patients were retrospectively divided into six normotensive (NT) and six hypertensive recipients (HT) maintained on monotherapy with a calcium channel blocker. Baseline glomerular filtration rates (GFR) were similar in NT and HT at T1 and T2. Renal functional reserve was identical in NT and HT at T1 (15 +/- 7 vs 18 +/- 13 ml/min/1.73 m2) but significantly greater in HT at T2 (11 +/- 5 vs 23 +/- 10 ml/min/1.73 m2; P < 0.05). At T2, baseline proximal tubule outflow (lithium clearance) was greater in HT (26 +/- 8 vs 16 +/- 3 ml/min/1.73 m2; P < 0.05), whereas fractional proximal reabsorption was less (54 +/- 11% vs 67 +/- 5%; P < 0.05). These results indicate that: (i) hypertensive recipients on calcium channel blocker therapy do not exhibit permanent glomerular hyperfiltration until 8 months after transplantation, and have a reduced proximal reabsorption; (ii) measurement of amino acid-stimulated GFR and renal functional reserve is a more sensitive method than that of baseline GFR for evaluating renal function and the effects of therapy in kidney recipients.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Amino Acids / administration & dosage
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / therapeutic use*
  • Cyclosporine / adverse effects
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hypertension, Renal / drug therapy*
  • Hypertension, Renal / etiology
  • Hypertension, Renal / physiopathology
  • Isradipine / therapeutic use
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / physiology*
  • Male
  • Middle Aged
  • Nifedipine / therapeutic use
  • Nitrendipine / therapeutic use
  • Renal Plasma Flow / drug effects
  • Retrospective Studies

Substances

  • Amino Acids
  • Calcium Channel Blockers
  • Cyclosporine
  • Nitrendipine
  • Nifedipine
  • Isradipine