Can lercanidipine improve renal function in patients with atherosclerotic renal artery stenosis undergoing renal artery intervention?

Curr Med Res Opin. 2015 Jan;31(1):177-82. doi: 10.1185/03007995.2014.960071. Epub 2014 Nov 26.

Abstract

Objective: To investigate the renal-protective effect of lercanidipine in patients undergoing renal artery intervention.

Methods: A prospective, single-center, cohort study was conducted and patients, 30-75 years of age, with atherosclerotic renal artery stenosis were consecutively enrolled between September 2011 and October 2012. Lercanidipine (10-20 mg/day) was regularly taken after the intervention. Follow up visits were performed at 3 and 6 months after the intervention. Serum creatinine, clinical blood pressure, 24 hour ambulatory blood pressure, pulse wave velocity, and 24 hour urine protein were assessed. Adverse events were recorded.

Results: In total, 55 patients (mean age 63.5 ± 8.9 years) were enrolled and 52 completed the study. Renal function, estimated glomerular filtration rate (eGFR) and 24 hour urine protein at 3 months after the intervention were not statistically different compared with the baseline. At 6 months after the intervention eGFR significantly increased versus baseline (78 ± 23 ml/min/1.73 m(2) vs 71 ± 21 ml/min/1.73 m(2), p = 0.021); 24 hour urine protein decreased significantly (0.02 g [IQR, 0.01-0.1] vs 0.03 g [IQR, 0.01-0.28], p = 0.042). Blood pressure control improved at 3 months and 6 months after the intervention. The need for antihypertensive drugs decreased; clinical systolic blood pressure, diastolic blood pressure and 24 hour average systolic blood pressure and diastolic blood pressure decreased. The pulse wave velocity decreased after 3 and 6 months. At the end of follow-up, none of the following adverse events occurred: death, dialysis, myocardial infarction or stroke. Mild lower extremity edema occurred in only one patient. No other side effects occurred.

Conclusions: This study showed that lercanidipine can improve renal function in patients undergoing renal artery intervention.

Keywords: 24-hour urine protein; Lercanidipine; Renal artery stenting; Renal function.

MeSH terms

  • Adult
  • Aged
  • Angioplasty, Balloon*
  • Antihypertensive Agents / therapeutic use*
  • Atherosclerosis / complications
  • Atherosclerosis / therapy*
  • Blood Pressure Monitoring, Ambulatory
  • Cohort Studies
  • Creatinine / blood
  • Dihydropyridines / therapeutic use*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • Pulse Wave Analysis
  • Renal Artery Obstruction / complications
  • Renal Artery Obstruction / therapy*
  • Stents
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Dihydropyridines
  • Creatinine
  • lercanidipine