Can amlodipine cause kidney problems
Pro Research Analysisby 
Searched over 200M research papers
Can Amlodipine Cause Kidney Problems?
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 for patients with pre-existing renal conditions.
Amlodipine and Renal Function in Hypertensive Patients
Blood Pressure Control and Renal Protection
Several studies have investigated the effects of amlodipine on renal function in hypertensive patients. Amlodipine has been shown to effectively reduce blood pressure without significantly worsening renal function. In a study involving hypertensive patients with renal impairment, amlodipine was found to control blood pressure effectively and was well-tolerated, with minimal adverse effects on renal function 49. Another study demonstrated that amlodipine therapy could correct renal abnormalities associated with hypertension, improving glomerular filtration rate and renal plasma flow 6.
Comparison with Other Antihypertensive Agents
When compared to angiotensin-converting enzyme inhibitors (ACEIs) like enalapril, amlodipine showed comparable efficacy in renoprotection over a one-year period. Both drugs managed to control blood pressure effectively, and the progression of renal dysfunction was similar between the two groups 2. However, amlodipine was better tolerated, with fewer patients discontinuing treatment due to adverse events 2.
Amlodipine in Renal Transplant Recipients
In normotensive renal transplant recipients, amlodipine was found to reduce serum creatinine levels significantly, suggesting a potential protective effect on renal function. This study highlighted that amlodipine did not adversely affect blood pressure or heart rate and was well-tolerated in combination with cyclosporin A, a common immunosuppressant used in transplant patients 1.
Experimental Models and Renal Outcomes
Animal Studies
Experimental studies in hypertensive rat models have provided mixed results. While amlodipine effectively reduced systemic blood pressure, it did not significantly impact glomerular filtration rate, kidney weight, or proteinuria in these models. These findings suggest that while amlodipine can manage hypertension, it may not prevent hypertensive nephrosclerosis or glomerular injury in all cases 3.
Amlodipine Overdose and Acute Kidney Injury
There are documented cases where amlodipine overdose has led to severe complications, including acute kidney injury (AKI). For instance, 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 7. This highlights the potential for serious renal complications in cases of overdose.
Conclusion
Overall, amlodipine appears to be a safe and effective antihypertensive agent for patients with renal impairment, with a low incidence of adverse renal effects when used at therapeutic doses. It compares favorably with other antihypertensive agents like ACEIs in terms of renoprotection and tolerability. However, caution is warranted in cases of overdose, as it can lead to severe renal and systemic complications. Further research is needed to fully understand the long-term renal effects of amlodipine, especially in diverse patient populations.
Sources and full results
Most relevant research papers on this topic
Renal effects of amlodipine in normotensive renal transplant recipients.
Amlodipine effectively reduced serum creatinine in normotensive renal transplant recipients after 8 weeks of treatment, and was well-tolerated and well-tolerated in concomitant administration with cyclosporin A.
RCTAmlodipine is comparable to angiotensin-converting enzyme inhibitor for long-term renoprotection in hypertensive patients with renal dysfunction: a one-year, prospective, randomized study.
Amlodipine provides similar long-term renal protection as ACEI and is better tolerated for hypertensive patients with renal dysfunction.
RCTEffects of amlodipine on glomerular filtration, growth, and injury in experimental hypertension.
Amlodipine reduces systemic blood pressure but does not affect kidney structure and function, suggesting it may not prevent hypertensive nephrosclerosis.
Non-RCT
Animal StudyRenal effects of amlodipine.
Amlodipine effectively reduces blood pressure and protects kidney function in hypertensive patients with renal impairment, but its mechanism of action differs from enalapril.
Non-RCTRenoprotective effect of losartan in comparison to amlodipine in patients with chronic kidney disease and hypertension--a report of the Japanese Losartan Therapy Intended for the Global Renal Protection in Hypertensive Patients (JLIGHT) study.
Losartan reduces proteinuria in patients with chronic kidney disease and hypertension, potentially contributing to its renal protective benefit beyond blood pressure control.
RCT
Highly CitedAmlodipine therapy corrects renal abnormalities encountered in the hypertensive state.
Amlodipine therapy can potentially reverse renal abnormalities in hypertensive patients, despite reducing mean arterial pressure.
RCTAmlodipine poisoning revisited: Acidosis, acute kidney injury and acute respiratory distress syndrome
Amlodipine overdose can cause severe complications, including metabolic acidosis, acute kidney injury, and acute respiratory distress syndrome, but in this case, the patient made a full recovery.
Case ReportProtective Effects of Amlodipine Pretreatment on Contrast-Induced Acute Kidney Injury And Overall Survival In Hypertensive Patients
Amlodipine treatment before contrast exposure protects hypertensive patients from contrast-induced acute kidney injury and prolongs survival.
Observational StudyReno protective role of amlodipine in patients with hypertensive chronic kidney disease
Amlodipine effectively manages hypertension in chronic kidney disease patients, improving their overall quality of life and reducing cardiovascular risks.
Efficacy and safety of amlodipine in hypertensive patients with renal dysfunction
Amlodipine effectively reduces blood pressure in hypertensive patients with renal dysfunction, with minimal or no aggravation of renal dysfunction.
Non-RCT