Comparative Effect of Calcium Channel Blockers on Glomerular Function in Hypertensive Patients with Diabetes Mellitus

Abstract

BACKGROUND: We conducted a retrospective cohort study to evaluate and compare the longitudinal effect of monotherapy with L-, L/T-, L/N-, and L/N/T-type calcium channel blockers (CCBs) on estimated glomerular filtration rate (eGFR), and to investigate the association of treatment duration with eGFR in diabetic patients with hypertension. METHODS: Using a clinical database, we identified new users of five CCBs, i.e. amlodipine (L-type, n = 693), nifedipine (L-type, n = 189), azelnidipine (L/T-type, n = 91), benidipine (L/N/T-type, n = 183), and cilnidipine (L/N-type, n = 61). We used a multivariable regression model to evaluate and compare the effects of these drugs on eGFR and serum creatinine, up to 12 months after initiation of study drug administration. RESULTS: There was no significant association between treatment duration and both eGFR and serum creatinine level with all CCB types. In addition, there was no significant difference in mean change in eGFR among the five CCBs, with any treatment duration. CONCLUSIONS: Our findings suggest that monotherapy with an L-, L/T-, L/N/T-, or L/N-type CCB may have little influence on renal function parameters and may be safely used in hypertensive patients with diabetes.