Kidney Week

Abstract: FR-PO975

Comparison of the Effect of Benidipine and Amlodipine on Clinical and Biochemical Parameters in CKD with Hypertension and Proteinuria

Session Information

• CKD Interventions: Trials and Quality Improvement
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Sirsat, Rasika, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India

Rasika Sirsat,

• Lute, Sneha Manoj, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India

Sneha Manoj Lute,

• Almeida, Alan F., PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India

Alan F. Almeida,

• Dey, Ayan Kumar, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India

Ayan Kumar Dey,

• Prasad, Khairwar Mahesh, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India

Khairwar Mahesh Prasad,

Background

Amlodipine targets L-type calcium channels on glomerular afferent arterioles resulting in their dilation, and leading to an increase in intraglomerular pressure and proteinuria. Benidipine blocks L-, N-, and T- type calcium channels which lower efferent arteriolar resistance and intraglomerular pressure, thereby reducing glomerular hypertension and proteinuria. We compared the effect of benidipine and amlodipine on proteinuria, blood pressure and estimated glomerular filtration rate (eGFR).

Methods

Sixty CKD patients with hypertension on maximum tolerated renin-angiotensin blockage whose UPCR (Urine protein creatinine ratio) >150 mg/gm were included in this study. Out of sixty patients, thirty patients were randomly assigned to either amlodipine (n=30) or benidipine (n=30). Blood pressure, serum creatinine, eGFR, UPCR, and serum albumin were monitored at baseline, 3^rd month and 6^th month. Continuous variables between the study drugs were compared by independent t-test (normal distribution) or Mann–Whitney U test (skewed distribution). Within-group comparisons at each follow-up for both drugs were done by Paired t-test (normal distribution) or Wilcoxon sign rank test (skewed distribution).

Results

Blood pressure decreased in both groups in the 3^rd and 6^th months. Systolic blood pressure (SBP) has decreased significantly in the benidipine group as compared to the amlodipine group (p-0.0014). UPCR values in benidipine and amlodipine groups changed from 2.89±2.17 to 1.42±1.34 and 2.27±1.46 to 2.47±1.55 after 6 months respectively (p-0.07). Despite not attaining the target systolic blood pressure (SBP<120 mm of Hg), it was observed that there was a significant decrease in UPCR at follow-up visits in the benidipine group. There was no significant change in eGFR in both groups at the end of the study. There was a significant improvement in serum albumin in benidipine-treated patients (p-0.001).

Conclusion

Benidipine is more effective than amlodipine in reducing proteinuria and blood pressure in chronic kidney patients with hypertension