Studies on protection of progression of renal impairment.

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Diet and blood pressure are important in the control of renal function in various renal diseases. Until now it has been made clear that appropriate restriction of salt and protein is effective in patients with renal impairment, but it is unknown that calcium(Ca) supplementation is useful for those patients. Furhtermore it is still controversial how much hypertension is harmful in pateints with renal impairment. In this study the effects of diet and antihypertensive drugs on renal function and blood pressure were studied in animal experiments and in patients with renal impairment.In the first animal experiment using DOCA-salt adriamycin treated rats, oral Ca supplementation ameliolated a part of chronic progression of renal damage by phosphate binding action. In the second animal experiment using 5/6 nephrectomized salt loaded spontaneously hypertensive rats, effects of various antihypertensive drugs on renal function and hypertension were studied. In this study it was demonstrated that … More an angiotensin converting enzyme(ACE) inhibitor and a Ca channel blocker are more effective than a diuretic to the progression of renal impairment and renal histological changes. However, there were no significact differences between the ACE inhibitor and the Ca channel blocker, although the Ca channel blocker didn't dilate the efferent arteriole different from the ACE inhibitor.In hypertensive patients with renal impairment 2 types of Ca channel blockers were demonstrated to be effective in the control of hypertension and renal function Ca channel blockers seemed to be safer than ACE inhibitors in patients with advance renal damage showing serum creatinine over 2 mg/dl.From these studies it was suggested that Ca supplementation in addition to salt and protein restriction is effective for prevention of renal impairment, and Ca channel blockers are also effective in the control of hypertension and renal function as well as ACE inhibitors, although the mechanims of action of Ca channel blockers were supposed to be different from that of ACE inhibitors. Less