Calcium Antagonists and Renal Protection: Current Status and Future Perspectives

Abstract

Since the introduction of calcium antagonists three decades ago, attention has focused on their beneficial effects on the management of symptomatic coronary artery disease, and on their ability to lower blood pressure. Although the renal vasodilatory properties of calcium antagonists were described as early as 1962 [1], this seminal finding was virtually ignored. Only during the past decade, has there been a rediscovery of this important effect and an increasing awareness that this class of drugs has beneficial effects on kidney function [2-6]. The demonstration that calcium antagonists can reverse renal vasoconstriction has eventuated in their recent utilization to augment renal perfusion in clinical settings in which renal hemodynamics are compromised. In addition, increasing evidence provides a theoretical framework for considering that calcium antagonists acting through mechanisms independently of their ability to alter renal microcirculatory dynamics, may retard progression of renal disease. The purpose of this review is to briefly consider the salutary effects of calcium antagonists both in settings of acute renal insufficiency, and independently their ability to retard progression of renal disease in patients with essential hypertension.