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Review
. 2022 Aug 10;14(8):e27847.
doi: 10.7759/cureus.27847. eCollection 2022 Aug.

Renal Function in Hypertensive Patients Receiving Cilnidipine and L-Type Calcium Channel Blockers: A Meta-Analysis of Randomized Controlled and Retrospective Studies

Mayakalyani Srivathsan  1 , Vikram Vardhan  2 , Azra Naseem  1 , Sayali Patil  1 , Vivek Rai  1 , Deepakkumar G Langade  1
Affiliations
Review

Renal Function in Hypertensive Patients Receiving Cilnidipine and L-Type Calcium Channel Blockers: A Meta-Analysis of Randomized Controlled and Retrospective Studies

Mayakalyani Srivathsan et al. Cureus. .

Abstract

Nearly 65%-95% of chronic kidney disease (CKD) patients have hypertension. Calcium-channel blockers are the first-line drugs for the treatment of hypertension, including hypertension with diabetes. This study aims to estimate the effect of an L-type calcium channel blocker (CCB), cilnidipine, on the renal function of hypertensive patients. Randomized control trials were selected from PubMed, Embase, Google Scholar, China National Knowledge Infrastructure (CNKI), Science Direct, Elton B. Stephens Company (EBSCO), Springer, Ovid, Cochrane Library, Medline, VIP, and Wanfang databases (from the date of databases' establishment till January 2022). Data were independently evaluated following the Cochrane risk-of-bias tool. The changes in serum creatinine (SCr), urinary protein excretion (UPE), urinary protein/creatinine ratio (UPCR), and estimated glomerular filtration rate (eGFR) before and after treatment, in percentages, were extracted for the meta-analysis. The mean difference (MD) and a CI of 95% were determined using RevMan 5.3 software. A total of 11 studies were analyzed. The standardized mean difference (SMD) between cilnidipine and L-type CCBs was -0.022, suggesting a reduced SCr with cilnidipine. For UPCR, the SMD value is 1.28. Although cilnidipine reduced UPCR in all four studies, the L-type CCBs reported a slight increase in UPCR. For eGFR, the SMD value was found to be 0.693. Cilnidipine had a more favorable effect on eGFR when compared to the L-type CCBs. While cilnidipine had similar effects on SCr to that of L-type CCBs, cilnidipine showed greater improvement in UPCR, UPE, and eGFR values.

Keywords: cilnidipine; hypertensive; l-type ccbs; meta-analysis; renal function.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA statement flowchart on the literature search and study selection process.
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2. Forest plot showing change in SCr.
The forest plot uses an effect measure of standardized mean difference [5,6,9,12,13,14,15]. The size of the bubble indicates the extent of SMD and the error bars represent 95% CIs for SMD. SCr: Serum creatinine; SMD: Standardized mean difference.
Figure 3
Figure 3. Funnel plot showing change in SCr.
SCr: Serum creatinine.
Figure 4
Figure 4. Forest plot showing change in UPCR.
The forest plot uses an effect measure of standardized mean difference [5,6,14]. The size of the square indicates the extent of SMD, and the error bars represent the 95% CIs for SMD. SMD: Standardized mean differences; UPCR: Urine protein-creatinine ratio.
Figure 5
Figure 5. Funnel plot showing change in UPCR.
UPCR: Urine protein-creatinine ratio.
Figure 6
Figure 6. Forest plot showing change in eGFR.
The forest plot uses an effect measure of standardized mean difference [9,12,13,14]. The size of the square indicates the extent of SMD, and the error bars represent the 95% CIs for SMD. SMD: Standardized mean differences; eGFR: Estimated glomerular filtration rate.
Figure 7
Figure 7. Funnel plot showing change in eGFR.
eGFR: Estimated glomerular filtration rate.
Figure 8
Figure 8. Risk of Bias (Cochrane RoB 2.0 tool).
The green bars indicate a low risk of bias, yellow bars indicate an unclear risk of bias (predominantly due to inadequate information regarding the concealment method), and red bars indicate a high risk of bias.
Figure 9
Figure 9. Mechanism of action of cilnidipine.
The image has been reproduced by the author (Mayakalyani Srivathsan) of this study, with permission from the source article [22].
See this image and copyright information in PMC

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References

    1. Renal denervation suppresses atrial fibrillation in a model of renal impairment. Liang Z, Shi XM, Liu LF, et al. PLoS One. 2015;10:0. - PMC - PubMed
    1. Sympathetic nerve activity in end-stage renal disease. Hausberg M, Kosch M, Harmelink P, et al. Circulation. 2002;106:1974–1979. - PubMed
    1. Blockade of N-type Ca2+ current by cilnidipine (FRC-8653) in acutely dissociated rat sympathetic neurones. Uneyama H, Takahara A, Dohmoto H, Yoshimoto R, Inoue K, Akaike N. Br J Pharmacol. 1997;122:37–42. - PMC - PubMed
    1. Long-term blockade of L/N-type Ca(2+) channels by cilnidipine ameliorates repolarization abnormality of the canine hypertrophied heart. Takahara A, Nakamura Y, Wagatsuma H, et al. http://2009. Br J Pharmacol. 2009;158:1366–1374. - PMC - PubMed
    1. Comparison between cilnidipine and amlodipine besilate with respect to proteinuria in hypertensive patients with renal diseases. Kojima S, Shida M, Yokoyama H. Hypertens Res. 2004;27:379–385. - PubMed

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