L-type calcium channel blocker use and proteinuria among children with chronic kidney diseases

Pediatric Nephrology (2021)Cite this article

Abstract

Background

Hypertension is common among children with chronic kidney disease (CKD), and dihydropyridine calcium channel blockers (dhCCBs) are frequently used as treatment. The impact of dhCCBs on proteinuria in children with CKD is unclear.

Methods

Data from 722 participants in the Chronic Kidney Disease in Children (CKiD) longitudinal cohort with a median age of 12 years were used to assess the association between dhCCBs and log transformed urine protein/creatinine levels as well as blood pressure control measured at annual visits. Angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) use was evaluated as an effect measure modifier.

Results

Individuals using dhCCBs had 18.8% higher urine protein/creatinine levels compared to those with no history of dhCCB or ACEi and ARB use. Among individuals using ACEi and ARB therapy concomitantly, dhCCB use was not associated with an increase in proteinuria. Those using dhCCBs had higher systolic and diastolic blood pressures.

Conclusions

Use of dhCCBs in children with CKD and hypertension is associated with higher levels of proteinuria and was not found to be associated with improved blood pressure control.

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Data Availability

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

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Acknowledgments

Data in this manuscript were collected by the Chronic Kidney Disease in children prospective cohort study (CKiD) with clinical coordinating centers (Principal Investigators) at Children’s Mercy Hospital and the University of Missouri–Kansas City (Bradley Warady, MD) and Children’s Hospital of Philadelphia (Susan Furth, MD, PhD), Central Biochemistry Laboratory (George Schwartz, MD) at the University of Rochester Medical Center, and data coordinating center (Alvaro Muñoz, PhD and Derek K. Ng, PhD) at the Johns Hopkins Bloomberg School of Public Health.

Code availability

Not applicable.

Funding

The CKiD Study is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Heart, Lung, and Blood Institute (U01-DK-66143, U01-DK-66174, U24-DK-082194, and U24-DK-66116). The CKiD website is located at https://statepi.jhsph.edu/ckid.

Author information

Author notes

  1. Kelsey L. Richardson and Donald J. Weaver Jr contributed equally to this work.

Affiliations

  1. Division of Pediatric Nephrology, Oregon Health & Sciences University, Portland, OR, USA

    Kelsey L. Richardson

  2. Pediatric Nephrology and Hypertension, Atrium Health Levine Children’s, 1000 Blythe Blvd, Str 200, Charlotte, NC, 28232, USA

    Donald J. Weaver Jr

  3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Derek K. Ng & Megan K. Carroll

  4. Division of Pediatric Nephrology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Susan L. Furth

  5. Division of Pediatric Nephrology, Children’s Mercy Hospital, Kansas City, MO, USA

    Bradley A. Warady

  6. Department of Pediatrics, University of Washington; Division of Nephrology, Seattle Children’s Hospital, Seattle, WA, USA

    Joseph T. Flynn

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  1. Kelsey L. Richardson
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Contributions

Research ideas and study design: KR, DW, MC, DN, SF, BW, and JF

Data analysis/interpretation: MC and DN

Supervision: SF, BW, and JF

Drafting/revision: KR, DW, MC, DN, SF, BW, and JF

Corresponding author

Correspondence to Donald J. Weaver Jr.

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Ethics approval

IRB approval at all participating sites in the Chronic Kidney Disease in children prospective cohort study was obtained.

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Informed consent/assent was obtained from all individual participants/parents included in the study.

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Each author contributed important intellectual content during manuscript drafting or revision, accepts personal accountability for the author’s own contributions, and agrees to ensure that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

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Richardson, K.L., Weaver, D.J., Ng, D.K. et al. L-type calcium channel blocker use and proteinuria among children with chronic kidney diseases. Pediatr Nephrol (2021). https://doi.org/10.1007/s00467-021-04967-3

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Keywords

  • Proteinuria
  • Chronic kidney disease
  • Children
  • Calcium channel blocker
  • Hypertension