Azelnidipine reduces urinary protein excretion and urinary liver-type fatty acid binding protein in patients with hypertensive chronic kidney disease

Am J Med Sci. 2007 Jun;333(6):321-6. doi: 10.1097/MAJ.0b013e318065c254.


Background: Hypoxia plays a significant role in the pathogenesis and progression of chronic renal disease. Urinary liver-type fatty acid binding protein (L-FABP) levels reflect the clinical prognosis of chronic renal disease. The calcium channel blocker azelnidipine has anti-oxidative properties and these may contribute to the beneficial effects of this drug. The aim of the present study was to determine whether azelnidipine and/or amlodipine affected urinary protein excretion or the urinary levels of 8-OHdG and L-FABP in hypertensive patients with mild chronic kidney disease (CKD).

Methods: Thirty moderately hypertensive chronic kidney disease patients were randomly assigned to 2 treatment groups: azelnidipine 16 mg once daily or amlodipine 5 mg once daily. Treatment was continued for 6 months. Urinary protein excretion and urinary levels of 8-OHdG and urinary L-FABP were measured before 3 and 6 months after the treatment period.

Results: Both drugs exhibited comparable and significant effects on the systolic and diastolic blood pressure. Azelnidipine decreased heart rate significantly after 3 and 6 months whereas amlodipine increased it significantly after 3 and 6 months. Urinary protein excretion, urinary 8-OHdG and urinary L-FABP levels decreased significantly after 3 months (p < 0.05) and 6 months (p < 0.05) in the azelnidipine group. In contrast, amlodipine showed little effect on urinary protein excretion or the urinary levels of 8-OHdG and L-FABP throughout the experimental period.

Conclusions: Azelnidipine is renoprotective in hypertensive patients with mild CKD and this action is, at least in part, due to the anti-oxidative effect.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • 8-Hydroxy-2'-Deoxyguanosine
  • Adult
  • Amlodipine / pharmacology
  • Amlodipine / therapeutic use
  • Antioxidants / pharmacology
  • Antioxidants / therapeutic use*
  • Azetidinecarboxylic Acid / analogs & derivatives*
  • Azetidinecarboxylic Acid / pharmacology
  • Azetidinecarboxylic Acid / therapeutic use
  • Blood Pressure / drug effects
  • Calcium Channel Blockers / pharmacology
  • Calcium Channel Blockers / therapeutic use*
  • Deoxyguanosine / analogs & derivatives
  • Deoxyguanosine / urine
  • Dihydropyridines / pharmacology
  • Dihydropyridines / therapeutic use*
  • Fatty Acid-Binding Proteins / urine*
  • Female
  • Heart Rate / drug effects
  • Humans
  • Hypertension / complications*
  • Hypertension / urine
  • Kidney Failure, Chronic* / drug therapy
  • Kidney Failure, Chronic* / etiology
  • Kidney Failure, Chronic* / urine
  • Male
  • Middle Aged
  • Proteinuria / metabolism*


  • Antioxidants
  • Calcium Channel Blockers
  • Dihydropyridines
  • Fatty Acid-Binding Proteins
  • Amlodipine
  • Azetidinecarboxylic Acid
  • 8-Hydroxy-2'-Deoxyguanosine
  • Deoxyguanosine
  • azelnidipine