N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis
Renin-angiotensin system (RAS) inhibitors and calcium channel blockers (CCB) are often used together in chronic kidney disease (CKD). The PubMed, EMBASE, and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) in order to explore better subtypes of CCB for the tr...
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MDPI AG
2023-02-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/16/3/338 |
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| author | Mingming Zhao Ziyan Zhang Zhiyu Pan Sijia Ma Meiying Chang Jiao Fan Shunxuan Xue Yuejun Wang Hua Qu Yu Zhang |
| author_facet | Mingming Zhao Ziyan Zhang Zhiyu Pan Sijia Ma Meiying Chang Jiao Fan Shunxuan Xue Yuejun Wang Hua Qu Yu Zhang |
| author_sort | Mingming Zhao |
| collection | DOAJ |
| description | Renin-angiotensin system (RAS) inhibitors and calcium channel blockers (CCB) are often used together in chronic kidney disease (CKD). The PubMed, EMBASE, and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) in order to explore better subtypes of CCB for the treatment of CKD. This meta-analysis of 12 RCTs with 967 CKD patients who were treated with RAS inhibitors demonstrated that, when compared with L-type CCB, N-/T-type CCB was superior in reducing urine albumin/protein excretion (SMD, −0.41; 95% CI, −0.64 to −0.18; <i>p</i> < 0.001) and aldosterone, without influencing serum creatinine (WMD, −3.64; 95% CI, −11.63 to 4.35; <i>p</i> = 0.37), glomerular filtration rate (SMD, 0.06; 95% CI, −0.13 to 0.25; <i>p</i> = 0.53), and adverse effects (RR, 0.95; 95% CI, 0.35 to 2.58; <i>p</i> = 0.93). In addition, N-/T-type CCB did not decrease the systolic blood pressure (BP) (WMD, 0.17; 95% CI, −1.05 to 1.39; <i>p</i> = 0.79) or diastolic BP (WMD, 0.64; 95% CI, −0.55 to 1.83; <i>p</i> = 0.29) when compared with L-type CCB. In CKD patients treated with RAS inhibitors, N-/T-type CCB is more effective than L-type CCB in reducing urine albumin/protein excretion without increased serum creatinine, decreased glomerular filtration rate, and increased adverse effects. The additional benefit is independent of BP and may be associated with decreased aldosterone (PROSPERO, CRD42020197560). |
| first_indexed | 2024-03-11T06:03:13Z |
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| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-11T06:03:13Z |
| publishDate | 2023-02-01 |
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| spelling | doaj.art-69b79243094d48dfa210d7cb2ce46e5b2023-11-17T13:11:24ZengMDPI AGPharmaceuticals1424-82472023-02-0116333810.3390/ph16030338N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-AnalysisMingming Zhao0Ziyan Zhang1Zhiyu Pan2Sijia Ma3Meiying Chang4Jiao Fan5Shunxuan Xue6Yuejun Wang7Hua Qu8Yu Zhang9Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Geriatrics, Zhejiang Aged Care Hospital, Hangzhou Normal University, Hangzhou 310015, ChinaXiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaDepartment of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, ChinaRenin-angiotensin system (RAS) inhibitors and calcium channel blockers (CCB) are often used together in chronic kidney disease (CKD). The PubMed, EMBASE, and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) in order to explore better subtypes of CCB for the treatment of CKD. This meta-analysis of 12 RCTs with 967 CKD patients who were treated with RAS inhibitors demonstrated that, when compared with L-type CCB, N-/T-type CCB was superior in reducing urine albumin/protein excretion (SMD, −0.41; 95% CI, −0.64 to −0.18; <i>p</i> < 0.001) and aldosterone, without influencing serum creatinine (WMD, −3.64; 95% CI, −11.63 to 4.35; <i>p</i> = 0.37), glomerular filtration rate (SMD, 0.06; 95% CI, −0.13 to 0.25; <i>p</i> = 0.53), and adverse effects (RR, 0.95; 95% CI, 0.35 to 2.58; <i>p</i> = 0.93). In addition, N-/T-type CCB did not decrease the systolic blood pressure (BP) (WMD, 0.17; 95% CI, −1.05 to 1.39; <i>p</i> = 0.79) or diastolic BP (WMD, 0.64; 95% CI, −0.55 to 1.83; <i>p</i> = 0.29) when compared with L-type CCB. In CKD patients treated with RAS inhibitors, N-/T-type CCB is more effective than L-type CCB in reducing urine albumin/protein excretion without increased serum creatinine, decreased glomerular filtration rate, and increased adverse effects. The additional benefit is independent of BP and may be associated with decreased aldosterone (PROSPERO, CRD42020197560).https://www.mdpi.com/1424-8247/16/3/338N-type calcium channel blockerT-type calcium channel blockerL-type calcium channel blockerchronic kidney diseaseproteinuria |
| spellingShingle | Mingming Zhao Ziyan Zhang Zhiyu Pan Sijia Ma Meiying Chang Jiao Fan Shunxuan Xue Yuejun Wang Hua Qu Yu Zhang N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis Pharmaceuticals N-type calcium channel blocker T-type calcium channel blocker L-type calcium channel blocker chronic kidney disease proteinuria |
| title | N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_full | N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_fullStr | N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_short | N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_sort | n t type vs l type calcium channel blocker in treating chronic kidney disease a systematic review and meta analysis |
| topic | N-type calcium channel blocker T-type calcium channel blocker L-type calcium channel blocker chronic kidney disease proteinuria |
| url | https://www.mdpi.com/1424-8247/16/3/338 |
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