Effects of benidipine on glomerular hemodynamics and proteinuria in patients with nondiabetic nephropathy.
Effects of benidipine on glomerular hemodynamics and proteinuria in patients with nondiabetic nephropathy.
复制标题
贝尼地平对非糖尿病肾病患者肾小球血流动力学和蛋白尿的影响。
作者：
T. Morikawa;M. Okumura;Y. Konishi;N. Okada;M. Imanishi
实验研究表明，一些长效钙拮抗剂降低肾小球高血压和抑制肾病进展，但缺乏临床证据。为了临床研究长效钙拮抗剂贝尼地平是否通过降低传出小动脉阻力降低肾小球毛细血管液压和减少蛋白尿，我们检查了非糖尿病肾病的高血压患者。受试者为7例慢性肾小球肾炎或肾小球硬化症患者。贝尼地平（4 mg/天）给药前和给药期间，研究了全身压力、肾小球血流动力学、钠敏感性指数（压力-尿钠排泄曲线的倒数）和尿蛋白排泄（总蛋白、白蛋白和免疫球蛋白G）。根据肾清除率、血浆总蛋白浓度和压力-尿钠排泄关系计算肾小球毛细血管液压和传入和传出小动脉阻力方面的肾小球血流动力学。贝尼地平通过降低输出小动脉的阻力，使平均动脉压从105 +/-5降至99 +/- 4 mmHg（p = 0.002;平均值+/- SD），肾小球压从48 +/- 8降至39 +/- 5 mmHg（p = 0.006）。贝尼地平使血压-尿钠排泄曲线变陡，使钠敏感指数中位数从0.099（0.084和0.117;第25和75次重复）降至0.048（0.017和0.058; p = 0.018）。尿蛋白排泄没有变化。我们的临床研究表明贝尼地平通过降低输出小动脉的阻力来降低肾小球压力，降低血压的钠敏感性，但对非糖尿病肾病患者的蛋白尿没有影响。
Experimental studies suggest that some long-acting calcium antagonists decrease glomerular hypertension and suppress the progression of nephropathy, but clinical evidence is lacking. To investigate clinically whether a long-acting calcium antagonist, benidipine, lowers glomerular capillary hydraulic pressure via a decrease in efferent arteriolar resistance and decreases proteinuria, we examined hypertensive patients with nondiabetic nephropathy. The subjects were 7 patients with chronic glomerulonephritis or glomerulosclerosis. Before and during the administration of benidipine (4 mg/day), systemic pressure, glomerular hemodynamics, the sodium sensitivity index (reciprocal of the pressure-natriuresis curve), and urinary excretion of proteins (total protein, albumin, and immunoglobulin G) were investigated. The glomerular hemodynamics in terms of glomerular capillary hydraulic pressure and resistance of afferent and efferent arterioles were calculated from the renal clearance, plasma total protein concentration, and pressure-natriuresis relationship. Benidipine lowered the mean arterial pressure from 105 +/-5 to 99 +/- 4 mm Hg (p = 0.002; mean +/- SD) and glomerular pressure from 48 +/- 8 to 39 +/- 5 mmHg (p = 0.006) by decreasing the resistance of efferent arterioles. Benidipine made the pressure-natriuresis curve steeper and decreased the median sodium sensitivity index from 0.099 (0.084 and 0.117; 25th and 75th percentiles) to 0.048 (0.017 and 0.058; p = 0.018). Urinary excretion of proteins did not change. Our clinical study showed that benidipine lowered the glomerular pressure by decreasing the resistance of efferent arterioles and decreased the sodium sensitivity of blood pressure, but did not affect proteinuria in patients with nondiabetic nephropathy.
硝苯地平和依那普利对未肾切除 SHR 肾小球结构和功能的影响。
影响因子：
19.6
作者：
Dworkin,LD;Feiner,HD;Parker,M;Tolbert,E
通讯作者：
Tolbert,E