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만성신질환 환자에서 레닌-안지오텐신 차단제와 efonidipine 병합요법이 단백뇨에 미치는 효과에 대한 다기관 관찰 연구

Other Titles
 Effect of Efonidipine on Proteinuria in Patients with Chronic Kidney Disease Receiving RAS Blockade 
 위정국  ;  정경환  ;  이태원  ;  이상호  ;  문주영  ;  차대룡  ;  하성규  ;  김순배  ;  곽임수  ;  임천규 
 Korean Journal of Nephrology, Vol.29(3) : 322-328, 2010 
Journal Title
 Korean Journal of Nephrology 
Issue Date
Calcium channel blocker ; Efonidipine ; Amlodipine ; Proteinuria
Purpose : Efonidipine, which inhibits both T- and L-type calcium channels, has been shown to be effective in reducing proteinuria and preserve renal function. This study was conducted to compare the effects of efonidipine versus amlodipine on the management of hypertension and proteinuria in patients with chronic kidney disease (CKD) receiving ACE inhibitors or ARB. Methods : This study included 41 CKD patients who were at stages 2-4 and had a urine spot protein/ creatinine ratio of >0.5. Patients were administered amlodipine (5 mg/day) and efonidipine (40 mg/ day) for 3 months in a cross-over design. Blood pressure and spot urine protein/creatinine ratio were compared before and after the cross-over treatment. Results : There were 24 male patients and 17 female patients. The mean age of the patients was 55.9±12.9 years. When the patients’ medication was changed to eponidifine, we obtained the following results. First, there were no significant changes in blood pressure and serum creatinine. Second, the urine spot protein/creatinine ratio was significantly decreased (before the cross-over, 2.9±2.6; after the cross-over, 2.3±1.9 g/g; p=0.02). Finally, the reduction rate of proteinuria was significantly higher in patients with CKD at stages 2-3 than in those with CKD at stage 4 after the cross-over (stage 2, - 26.1%; stage 3, -17%; stage 4, +12.8%; p=0.03). Conclusion : It is concluded that efonidipine may significantly decrease proteinuria compared with amlodipine in CKD patients receiving ACE inhibitors or ARB. Further double-blind clinical trials with a larger sample size are needed to confirm our results
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ha, Sung Kyu(하성규)
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