Can amlodipine cause kidney damage
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Can Amlodipine Cause Kidney Damage?
Introduction to Amlodipine and Kidney Health
Amlodipine is a widely used calcium channel blocker primarily prescribed for managing hypertension and angina. Given its extensive use, understanding its impact on kidney health is crucial, especially since the kidneys play a vital role in filtering waste and maintaining overall bodily homeostasis.
Protective Effects of Amlodipine on Kidneys
Renal Protection in Diabetic and Hypertensive Models
Several studies have demonstrated the protective effects of amlodipine on renal function. In diabetic rat models, amlodipine was shown to reduce renal apoptosis, improve creatinine clearance, and decrease urine albumin excretion, indicating a protective effect against diabetic nephropathy. Similarly, in hypertensive patients with renal impairment, amlodipine was found to reduce blood pressure and attenuate the progression of renal histological damage, comparable to the effects of angiotensin-converting enzyme (ACE) inhibitors .
Contrast-Induced Acute Kidney Injury (CI-AKI)
Amlodipine has also been studied for its effects on contrast-induced acute kidney injury (CI-AKI), a common complication in hypertensive patients undergoing imaging procedures. A large cohort study found that pre-treatment with amlodipine significantly reduced the incidence of CI-AKI and improved overall survival rates in hypertensive patients.
Amlodipine and Nephrotoxicity
Overdose and Acute Kidney Injury
While therapeutic doses of amlodipine generally show protective renal effects, overdose scenarios present a different picture. Case reports have documented instances of acute kidney injury (AKI) following amlodipine overdose. For example, an 18-year-old girl who ingested a large dose of amlodipine developed severe metabolic acidosis, AKI, and acute respiratory distress syndrome, although she eventually recovered with conservative management. Another case highlighted successful treatment of AKI following a massive amlodipine overdose, emphasizing the potential for severe renal complications in overdose situations .
Comparative Studies with Other Calcium Channel Blockers
Comparative studies have shown that amlodipine, along with nifedipine, can mitigate gentamicin-induced renal tubular toxicity, whereas nitrendipine either had no effect or worsened the condition. This suggests that amlodipine has a protective antioxidative effect on renal tissues.
Clinical Implications and Conclusion
Long-Term Renoprotection
Long-term studies have indicated that amlodipine is comparable to ACE inhibitors in providing renoprotection for hypertensive patients with chronic renal dysfunction. A one-year prospective study demonstrated that amlodipine effectively maintained renal function and was better tolerated than ACE inhibitors, making it a viable option for long-term management of hypertension in patients with renal impairment.
Conclusion
In summary, amlodipine generally exhibits protective effects on renal function in both diabetic and hypertensive models, and it can reduce the incidence of CI-AKI. However, in cases of overdose, amlodipine can lead to acute kidney injury, highlighting the importance of adhering to prescribed dosages. Overall, amlodipine remains a valuable medication for managing hypertension with a favorable renal safety profile when used appropriately.
Sources and full results
Most relevant research papers on this topic
1
The Renal Protective Effect of Amlodipine in Diabetic Rats
1
0 Citations
2008
5
Renal effects of amlodipine.
5
8 Citations
1995