Assessment of effects of amlodipine and cilnidipine on urea and creatinine levels in hypertensive patients - a comparative study

Background: Hypertension is one the leading cause of chronic kidney disease (CKD) . The physiologic and pathologic renal changes in essential hypertension, often precede changes identifiable in other organs, but whether they precede or follow the onset of the hypertension itself has not been determined. According to AHA and JNC VIII calcium channel blockers are first line drug in treatment of hypertension. The equipotent antihypertensive effect of Cilnidipine and Amlodipine in their equivalent dose has been demonstrated in number of studies.
Objectives: To compare and evaluate the effects of CCBs Amlodipine and Cilnidipine on renal parameters like urea and creatinine amongst hypertensive patients
Methods: Total 258 patients were screened, examined and enrolled as study participants during that period. The enrolled patients were then divided as (1) Hypertensive patient (n=159) - selected patients received either Amlodipine (2.5 to 10mg) or cilnidipine (5 to 20 mg) with or without ARB. (2) Hypertensive with controlled diabetic patients (n=99) - selected patients received either Amlodipine (2.5 to 10mg) or cilnidipine (5 to 20 mg) with or without ARB alongwith antidiabetic medication. Serun urea and creatinine were recorded at the baseline and periodic monitoring was done at 3,6 and 12 months.
Results: Regarding reno protective effect, the elevation of creatinine was more suppressed by Cilnidipine than Amlodipine. Both of drug have no action on blood urea level.
Conclusions: Cilnidipine improves the creatinine levels and hence is considered to have a better reno protective profile than Amlodipine amongst hypertensive patients.