Summary
Organ protection is the main goal in the treatment of high blood pressure. Consequently, this protective capacity should be one of the main characteristics of any drug used in the treatment of hypertension. A renal protective agent should protect the kidney from intrinsic renal vasoconstrictors and exogenous agents, and should also protect, or at least delay, the decline in renal function in the presence of renal insufficiency, by mechanisms other than increasing glomerular filtration pressure. Verapamil protects mesangial cells from the reduction in surface area induced by endothelin in vitro. In human subjects, it minimises the renal impairment provoked by the administration of cisplatin, and in mice it protects superficial cortical blood flow from the vasoconstriction elicited by cyclosporin. Finally, verapamil may protect from glomerulosclerosis as a result of its capacity to inhibit mesangial cell replication.
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Agatstein EH, Fairer JH, Kaplan LM, Randazzo RF, Glassock RJ, et al. The effect of verapamil in reducing the severity of acute tubular necrosis in canine renal autotransplants. Transplantation 44: 355–357, 1987
Bauer JH, Reams G. Short- and long-term effects of calcium entry blockers on the kidney. American Journal of Cardiology 59: 66A–71A, 1987
Boero R, Quarello F, Guarena C, Piccoli G. Verapamil in arterial hypertension with renal disease. Nephron 44: 80, 1986
Eiskjaer H, Pedersen EB, Rasmussen LM, Jesperen B. Sustained release verapamil in renal hypertension. European Journal of Clinical Pharmacology 33: 549–555, 1988
Harris D, Hammond WS, Burke TJ, Schrier RW. Verapamil protects against progression of experimental chronic renal failure. Kidney International 31: 41–46, 1987
Kubo SH, Cody RJ, Covit AB, Feldschuh J, Laragh JH. The effects of verapamil on renal blood flow, renal function, and neurohormonal profiles in patients with moderate to severe hypertension. Journal of Clinical Hypertension 3: 38S–46S, 1986
Leonetti G, Sala C, Bianchini C, Terzoli L, Zanchetti A. Anti-hypertensive and renal effects of orally administered verapamil. European Journal of Clinical Pharmacology 18: 375–382, 1980
López-Farré A, Montañés I, Fernández-Cruz A, López-Novoa JM. Verapamil blunts the effect of endothelin on renal function in rats. Medical Science Research 18: 323–324, 1990
Macías-Núñez JF, García Iglesias C, Santos J, Sanz E, López-Novoa JM. Influence of plasma renin content, intrarenal angiotensin II, captopril and calcium channel blockers on the vasoconstriction and renin release promoted by adenosine in the kidney. Journal of Laboratory and Clinical Medicine 106: 562–567, 1985
Nakaki T, Nakayama M, Yamamoto S, Kato R. Endothelin-mediated stimulation of DNA synthesis in vascular smooth muscle cells. Biochemical Biophysical Research Communications 158: 880–883, 1989
Offerman JJG, Meijer S, Sleijfer DTh, Mulder NH, Donker AJM, et al. The influence of verapamil on renal function in patients treated with cisplatin. Clinical Nephrology 24: 249–255, 1985
Rahn KH, Van Bortel LM, Mooy JM. The use of calcium antagonists in patients with renal failure. Journal of Hypertension 5(Suppl. 4): 67–69, 1987
Rooth P, Davidson I, Diller K, Taljedal IB. Protection against cyclosporine-induced impairment of renal microcirculation by verapamil in mice. Transplantation 45: 433–437, 1988
Shimamura T, Morrison AB. A progressive glomerulosclerosis occurring in partial five-sixths nephrectomized rats. American Journal of Pathology 79: 95, 1975
Sorensen SS, Thomsen OO, Danielsen H, Pedersen EB. Effect of verapamil on renal plasma flow, glomerular filtration rate, plasma angiotensin II, aldosterone and arginine vasopressin in essential hypertension. European Journal of Clinical Pharmacology 29: 257–261, 1985
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García-Cosmes, P., Mortezo, A., López-Novoa, J.M. et al. Is Renal Protection with Calcium Antagonists Possible?. Drugs 44 (Suppl 1), 99–102 (1992). https://doi.org/10.2165/00003495-199200441-00018
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DOI: https://doi.org/10.2165/00003495-199200441-00018