Does amlodipine cause kidney damage
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Amlodipine and Kidney Damage: A Comprehensive Review
Introduction to Amlodipine and Kidney Health
Amlodipine, a dihydropyridine calcium channel blocker, is widely used to manage hypertension and angina. Given its extensive use, understanding its impact on kidney health is crucial, especially since the kidneys are vital organs susceptible to damage from various medications.
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 rat models, amlodipine reduced systolic blood pressure, urinary protein excretion, and renal histological damage, suggesting it can mitigate hypertensive renal injury .
Comparison with Other Antihypertensive Agents
Amlodipine's renal protective effects have been compared with those of angiotensin-converting enzyme (ACE) inhibitors. Studies indicate that while both amlodipine and ACE inhibitors reduce blood pressure and protect renal function, their mechanisms differ. Amlodipine does not significantly dilate the efferent arteriole, unlike ACE inhibitors, but still offers comparable renoprotection .
Amlodipine in Clinical Settings
Effects in Hypertensive Patients with Renal Impairment
Clinical studies have shown that amlodipine effectively reduces blood pressure in hypertensive patients with renal impairment without significantly altering serum creatinine or blood urea nitrogen levels. This suggests that amlodipine does not exacerbate renal dysfunction in these patients . Additionally, in hypertensive patients undergoing contrast media procedures, amlodipine pretreatment was associated with a lower incidence of contrast-induced acute kidney injury (CI-AKI) and improved overall survival.
Renal Transplant Recipients
In normotensive renal transplant recipients, amlodipine was found to reduce serum creatinine levels and showed a trend towards increased renal plasma flow, indicating potential benefits in this specific patient population.
Potential Risks and Overdose Concerns
Amlodipine Overdose
While therapeutic doses of amlodipine are generally safe, overdose can lead to severe complications, including acute kidney injury (AKI). Case reports have documented instances of AKI following significant amlodipine overdose, often in conjunction with other symptoms such as refractory hypotension and noncardiogenic pulmonary edema. These cases highlight the importance of cautious dosing and prompt management in overdose situations .
Interaction with Other Nephrotoxic Agents
Amlodipine has also been studied in the context of nephrotoxic agents like gentamicin. Research indicates that amlodipine can mitigate gentamicin-induced renal tubular toxicity, suggesting a protective role against certain drug-induced nephrotoxicity.
Conclusion
Overall, evidence suggests that amlodipine does not cause kidney damage when used at therapeutic doses and may even offer protective benefits in various renal conditions. However, caution is warranted in cases of overdose, where severe renal and systemic complications can occur. Further research is needed to fully elucidate the long-term renal effects of amlodipine, especially in diverse patient populations.
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
3
Renal effects of amlodipine.
3
8 Citations
1995