Nephrology Dialysis Transplantation, Vol 12, Issue 7 1441-1447, Copyright © 1997 by Oxford University Press
JK Rockstroh, HP Schobel, G Vogt-Ladner, I Hauser, HH Neumayer and RE Schmieder
Left ventricular hypertrophy is well established as a blood pressure
independent cardiovascular risk factor in patients on renal replacement
therapy. The effects of antihypertensive treatment on myocardial structure
and function in renal transplant recipients have been so far only rarely
investigated. In a double-blind, placebo-controlled study patients were
randomized to the calcium channel blocker nitrendipine or placebo if the
transplanted kidney had developed a stable phase. Normotensive patients
received nitrendipine 2 x 5 mg daily or placebo, hypertensive patients
received 2 x 10 mg up to 2 x 20 mg nitrendipine daily or placebo. To
achieve adequate blood pressure control, all patients with still elevated
blood pressure on study medication received antihypertensive drugs other
than calcium channels blockers. Ambulatory blood pressure recording and
2D-guided M-mode echocardiography were performed at baseline and upon
completion of the study. In addition, laboratory workup (including serum
creatinine and lipids) was done, and serum aldosterone, plasma renin
activity, plasma angiotensin II and blood glucose levels were measured in
all patients at baseline and after at least 12 months of therapy.
Ambulatory blood pressure was almost identical between both groups at study
baseline and follow-up. In renal transplant patients on nitrendipine,
posterior wall thickness (-0.10 +/- 1.77 mm) and septal wall thickness
(-0.83 +/- 2.23 mm) did not change significantly from baseline. In
contrast, posterior wall thickness (0.71 +/- 0.92 mm, P < 0.01) and
septal wall thickness (0.97 +/- 2.20 mm, P < 0.05) increased in patients
on placebo, which differed from the observed changes on nitrendipine
(ANOVA: P = 0.093 and P = 0.048, respectively). Relative wall thickness, a
parameter for concentric left ventricular hypertrophy, became numerically
smaller on nitrendipine therapy from 0.46 +/- 0.07 to 0.44 +/- 0.09 (-0.02
+/- 0.09, NS) but increased from 0.42 +/- 0.08 to 0.48 +/- 0.08 in the
placebo arm (+0.04 +/- 0.08, P < 0.02), which was also significant
between the two groups (ANOVA: P = 0.036). Endocrine parameters, lipids and
blood glucose were not different between the two groups. We conclude from
these data that the calcium channel blocker nitrendipine exerted beneficial
effects on cardiac structure in patients after renal transplantation
independent of blood pressure.
ORIGINAL ARTICLES
Blood pressure independent effects of nitrendipine on cardiac structure in patients after renal transplantation
Department of Medicine and Nephrology, University of Erlangen-Nurnberg, Germany.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. Stewart, A. G. Jardine, and J. D. Briggs Ischaemic heart disease following renal transplantation Nephrol. Dial. Transplant., February 1, 2000; 15(2): 269 - 277. [Full Text] [PDF]
|
|
|
|
|
|
E. Mcgregor, G. Stewart, R. S. C. Rodger, and A. G. Jardine Early echocardiographic changes and survival following renal transplantation Nephrol. Dial. Transplant., January 1, 2000; 15(1): 93 - 98. [Abstract] [Full Text] [PDF]
|
|