AI Article Synopsis
- Intradialytic hypertension (HTN) in hemodialysis patients may relate to increased sympathetic nerve activity, leading to the hypothesis that the calcium channel blocker cilnidipine can help lower systolic blood pressure (SBP) during dialysis.
- In a study involving 51 patients with intradialytic-HTN, participants were divided into control and cilnidipine groups, with the latter receiving 10 mg/day of the medication for 12 weeks.
- Results showed cilnidipine significantly reduced post-dialytic SBP and the average intradialytic SBP elevation, indicating potential effectiveness in managing SBP during hemodialysis, despite the change not being statistically significant.
Article Abstract
Background: Intradialytic hypertension (HTN), which is one of the poor prognostic markers in patients undergoing hemodialysis, may be associated with sympathetic overactivity. The L/N-type calcium channel blocker, cilnidipine, has been reported to suppress sympathetic nerves activity in vivo. Therefore, we hypothesized that cilnidipine could attenuate intradialytic systolic blood pressure (SBP) elevation.
Methods: Fifty-one patients on chronic hemodialysis who had intradialytic-HTN (SBP elevation ≥10 mmHg during hemodialysis) and no fluid overload were prospectively randomized into two groups: control and cilnidipine groups. Cilnidipine group patients took cilnidipine (10 mg/day) for 12 weeks. The primary endpoint was the change in the intradialytic SBP elevation before and after the 12-week intervention.
Results: Before the intervention, no differences were observed in age, sex or pre-dialytic SBP (148.5 ± 12.9 vs. 148.3 ± 19.3 mmHg) between the two groups. Intradialytic SBP elevation was unchanged in the control group. Cilnidipine significantly lowered the post-dialytic SBP with an attenuation of the intradialytic SBP elevation from 12.0 ± 15.4 mmHg to 4.8 ± 10.1 mmHg. However, the observed difference in the intradialytic SBP elevation by cilnidipine did not reach statistical significance (group×time interaction effect p = 0.25). Cathecolamine levels were unaffected by the intervention in both groups.
Conclusion: Cilnidipine lowers both the pre- and post-dialytic SBP and might attenuate intradialytic SBP elevation. Therefore, cilnidipine may be effective in lowering SBP during HD in patients with intradialytic-HTN.
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| http://dx.doi.org/10.1080/10641963.2018.1445753 | DOI Listing |
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