www.ijbcp.com International Journal of Basic & Clinical Pharmacology | October 2017 | Vol 6 | Issue 10 Page 2482 IJBCP International Journal of Basic & Clinical Pharmacology Print ISSN: 2319-2003 | Online ISSN: 2279-0780 Original Research Article Antiproteinuric effects of cilnidipine and amlodipine as add on therapy in hypertensive patients with chronic renal disease: a comparative study Y. Nisha Maheswari 1 , B. Meenakshi 1 *, V. Ramasubramanian 2 , J. Ezhil Ramya 1 INTRODUCTION Chronic kidney disease (CKD) comprises of a spectrum of different pathophysiological processes associated with abnormal kidney function and progressive decline in glomerular filtration rate. Diabetic nephropathy is the most common cause of chronic renal failure worldwide. It is mainly due to epidemic increase in obesity, metabolic syndrome and type II diabetes mellitus. Hypertension is the major consequence of chronic renal disease which develops early during the course of the disease. 1 Uncontrolled hypertension and proteinuria are the most crucial risk factors for rapid progression of kidney disease and development of extrarenal complications such as cardiovascular disease and stroke. 2 Thus strict control of blood pressure and suppression of proteinuria are the essential goals of antihypertensive therapy in patients with chronic renal disease. The National kidney foundation clinical practice guidelines recommend a blood pressure goal of <130mmHg systolic and <80mmHg diastolic for all patients with chronic renal disease. 3 Renin angiotensin inhibitors such as ACE (Angiotensin converting enzyme) inhibitors and ARB (Angiotensin receptor blockers) are the widely recognized renoprotective agents. These agents effectively reduce proteinuria than any other antihypertensive agents. 4 ABSTRACT Background: Cilnidipine is a dual blocker of L type and N type calcium channel and dilates both afferent and efferent arterioles. Hence it increases renal blood flow and reduces glomerular pressure ultimately reducing proteinuria. Thus, it may exert renoprotective effects. The present study was designed to compare the antiproteinuric effects of cilnidipine and amlodipine in hypertensive patients with chronic kidney disease as add on therapy to patients on losartan. Methods: This is a randomized, open label, prospective, parallel group study conducted in the out patient Department of Nephrology. The trial enrolled Diabetic CKD patients with hypertension and with spot urine protein creatinine ratio (PCR) ≥0.2 who were being treated with T. Losartan 50mg/day for >2 months. The subjects were then randomly assigned to 2 groups to receive either cilnidipine 10-20mg/day (Group A-46) or amlodipine 5-10mg/day (Group B- 50). The drugs were given for a duration of 6 months for each patient. The dose of losartan (50mg/day) was not adjusted throughout the study. Results: After 6 months, a significant reduction in systolic and diastolic blood pressure was seen in both the groups. The decrease in urinary protein creatinine ratio was significantly higher in cilnidipine group rather than amlodipine group. Thus, cilnidipine exerted greater antiproteinuric effect than amlodipine. Conclusions: Cilnidipine has antihypertensive effect equivalent to amlodipine but addition of cilnidipine rather than amlodipine to losartan decreased urine protein excretion in diabetic chronic kidney disease patients. Keywords: Amlodipine, Chronic kidney disease, Cilnidipine, Losartan, Proteinuria DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20174380 1 Department of Pharmacology, 2 Department of Nephrology, Government Tirunelveli Medical College, Tirunelveli, Tamilnadu, India Received: 05 August 2017 Revised: 23 August 2017 Accepted: 29 August 2017 *Correspondence to: Dr. B. Meenakshi, Email: bmeenakshibala17@ gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open- access article distributed under the terms of the Creative Commons Attribution Non- Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.