Is amlodipine hard on the kidneys
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Impact of Amlodipine on Kidney Health
Amlodipine and Kidney Function in Hypertensive Models
Amlodipine, a calcium channel blocker, has been extensively studied for its effects on kidney function, particularly in hypertensive models. Research indicates that while amlodipine effectively reduces systemic blood pressure, it does not significantly impact glomerular filtration rate (GFR), kidney weight, proteinuria, or morphological evidence of glomerular injury in hypertensive rats. Additionally, in spontaneously hypertensive rats, amlodipine did not reduce glomerular pressure or size, nor did it inhibit platelet aggregation, suggesting limited efficacy in preventing hypertensive nephrosclerosis.
Renal Effects in Normotensive Renal Transplant Recipients
In normotensive renal transplant recipients, amlodipine has shown some positive effects. A study demonstrated that amlodipine significantly reduced serum creatinine levels and showed a trend towards increased effective renal plasma flow, without affecting GFR or lithium clearance. This suggests that amlodipine may have a beneficial role in improving certain aspects of renal function in this specific patient population.
Comparative Studies with ACE Inhibitors
Comparative studies between amlodipine and angiotensin-converting enzyme inhibitors (ACEIs) have shown that both drugs have similar effects on renal function in hypertensive patients with renal impairment. Over a one-year period, both treatments resulted in comparable changes in serum creatinine and creatinine clearance, with amlodipine being better tolerated. This indicates that amlodipine can be as effective as ACEIs in managing renal dysfunction in hypertensive patients.
Renal Hemodynamics and Fibrosis
Amlodipine has been found to positively influence renal hemodynamics by reversing angiotensin II-induced decrements in GFR and partially restoring renal perfusate flow, thereby increasing filtration fraction. Additionally, in a mouse model of renal interstitial fibrosis, amlodipine reduced the expression of fibrosis markers and ameliorated fibrosis, suggesting a protective effect against renal interstitial fibrosis.
Protective Effects Against Nephrotoxicity
Amlodipine has also demonstrated protective effects against nephrotoxicity induced by gentamicin, a common antibiotic. Studies showed that amlodipine effectively reversed gentamicin-induced changes in urinary protein, serum creatinine, and blood urea nitrogen levels, and mitigated oxidative stress and renal tubular cell apoptosis. This highlights amlodipine's potential in protecting against drug-induced renal damage.
Conclusion
Overall, while amlodipine effectively reduces blood pressure and shows some renal protective effects, its impact on kidney function varies depending on the context. In hypertensive models, it does not significantly prevent glomerular injury or reduce glomerular pressure. However, in normotensive renal transplant recipients and in cases of drug-induced nephrotoxicity, amlodipine has shown beneficial effects. Therefore, the use of amlodipine in patients with kidney concerns should be carefully considered based on individual patient conditions and specific renal health needs.
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