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Renoprotective effect of calcium channel blockers (amlodipine) and angiotensin converting enzyme inhibitors (enalapril) in hypertensive patients with chronic kidney disease (gaza strip)

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Author: 
Hidaya S. Saker, Amin T. Hamed, Amal F. Jamee and Mahmoud J. Wadi
Abstract: 

Chronic Kidney Disease (CKD) is one of the most serious complications of hypertension and is the leading cause of end-stage renal disease (ESRD). Angiotensin Converting Enzyme inhibitors (ACEIs) and Calcium Channel Blockers (CCBs) play relevant role in the control of the blood pressure and in preventing progression of CKD. The purpose of this study was to evaluate the renoprotective effect of Amlodipine (calcium channel blocker) monotherapy and in combination with Enalapril (angiotensin converting enzyme inhibitor) in hypertensive patients with CKD in Gaza Strip. To achieve this purpose, this study was conducted on 50 hypertensive patients with CKD selected from Nasser medical complex, Kidney and Dialysis Department, divided into two groups. The first group (n=25) was treated with Amlodipine (5-10 mg/day) and the second group (n=25) was treated with Amlodipine (5-10 mg/day) and Enalapril (10-20 mg/day) combination. All patients were followed-up for six months by measuring urinary albumin excretion (UAE) rate, serum creatinine level and CrCl before and after 2, 4 and 6 months of treatment. The results showed a significant reduction in UAE rate among patients who used Amlodipine and Amlodipine/Enalapril combination after 6 months of treatment. In addition, the results also showed a significant reduction in serum creatinine level after 6 months of Amlodipine alone and in combination treatment. On the other hand, a significant increase in CrCl level among patients in both groups was observed during the study period (6 months). The study revealed that the use of Amlodipine/Enalapril combination had more pronounced renoprotective effect than Amlodipine monotherapy among hypertensive patients with CKD.

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               Prof. Dr. ISMAIL YILDIRIM

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