Abstract

A COMPARATIVE STUDY TO EVALUATE THE EFFECT OF RENIN ANGIOTENSIN ALDOSTERONE SYSTEM INHIBITORS, RENIN ANGIOTENSIN ALDOSTERONE SYSTEM INHIBITORS WITH CILNIDIPINE AND RENIN ANGIOTENSIN ALDOSTERONE SYSTEM INHIBITORS WITH OTHER ANTIHYPERTENSIVES IN PROTEINURIA

*Archana P., Dr. M. P. Narmadha and Dr. P. M. Jayaraj

ABSTRACT

Background: Diabetic nephropathy is the leading cause of end-stage-kidney disease worldwide. The degree of proteinuria in patients with diabetes correlates strongly with an increase in the progression of nephropathy. The pharmacological blockade of renin angiotensin system with RAASi inhibitors are considered to be the first line treatment for proteinuria. Monotherapy is usually insufficient to control hypertension. Cilnidipine is a new L/N type calcium channel blocker used in combination with RAASi for treating hypertension. Objective: The aim of the study was to assess whether cilnidipine, the new L/N type calcium channel blocker is superior to other antihypertensives in controlling proteinuria and to assess the glycemic status of the patients in the study and the effect of the drugs on renal function. Methodology: Study was a prospective observational cohort study conducted in nephrology OPD of PK Das Hospital, Vaniamkulam. A total of 80 patients who satisfied inclusion and exclusion criteria were randomly allocated to 3 groups based on their medication, i.e. RAASi only, RAASi with cilnidipine and RAASi with other antihypertensives. Twenty patients in each group completed the study. Lab investigations like Urine PC ratio, serum creatinine, GFR, serum uric acid and serum potassium were done at the base line and after 3 months of treatment. Baseline HbA1C levels also assessed. The results were statistically analyzed by using one way analysis of variance. Results and conclusion: The study concludes that there was no significant difference between these groups in their antiproteinuric effects which suggested that cilnidipine is not superior to RAASi and RAASi plus other antihypertensives in reducing proteinuria. Serum creatinine, serum uric acid, GFR, serum potassium showed no significant difference between the groups.

Keywords: Cilnidipine, Proteinuria, Renin Angiotensin Aldosterone inhibitors (RAASi), Protein creatinine ratio.