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Nephrol Dial Transplant (2000) 15: 581-585
© 2000 European Renal Association-European Dialysis and Transplant Association

Invited Comment

Calcium channel blockers – the effect on renal changes in clinical and experimental diabetes: an overview

Birgitte Nielsen and Allan Flyvbjerg

Medical Research Laboratory M (Diabetes and Endocrinology), Institute of Experimental Clinical Research, Aarhus University Hospital, Aarhus, Denmark

Introduction

Diabetic nephropathy is the most important cause of end-stage renal failure in the Western world. It is preceded by increased urinary albumin excretion (UAE) in the microalbuminuric range (30–300 mg/ 24 h, i.e. incipient nephropathy), often in association with hypertension. Antihypertensive treatment with angiotensin-converting-enzyme inhibitors (ACEIs) is effective in preventing or postponing the development of overt nephropathy (i.e. UAE >300 mg/24 h) [1]. Other antihypertensive drugs, such as calcium channel blockers (CCBs), may also be effective in the treatment of diabetic kidney disease, but their preventive effect is controversial. In addition, it is still unknown whether dihydropyridine CCBs and non-dihydropyridine CCBs are equally effective. Further, the safety of CCB treatment in diabetics has been debated, since increased incidence of cardiovascular mortality has been reported during nisoldipine treatment in non-insulin-dependent diabetes mellitus (NIDDM). Thus, this paper will present an updated review of experimental and clinical data concerning the renoprotective . . . [Full Text of this Article]

Animal models of diabetic nephropathy

Insulin-dependent diabetic patients

Non-insulin-dependent diabetic patients

Conclusions and outlook

Notes

References


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