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