Journal Article

Amlodipine reduces cyclosporin-induced hyperuricaemia in hypertensive renal transplant recipients

Jacques Chanard, Olivier Toupance, Sylvie Lavaud, Bruno Hurault de Ligny, Corine Bernaud and Bruno Moulin

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 18, issue 10, pages 2147-2153
Published in print October 2003 | ISSN: 0931-0509
Published online October 2003 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfg341
Amlodipine reduces cyclosporin-induced hyperuricaemia in hypertensive renal transplant recipients

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Background. Hypertension and hyperuricaemia are common side-effects of cyclosporin A (CsA) treatment in renal transplant recipients. While it is well established that the calcium channel blocker amlodipine can control CsA-induced hypertension effectively in this patient population, recent evidence suggests amlodipine might also reduce hyperuricaemia. The present study was designed to compare the effects of the calcium channel blocker amlodipine (5–10 mg/day) and the β-adrenoceptor antagonist tertatolol (5–10 mg/day) on CsA-induced hyperuricaemia in post-renal transplant recipients with hypertension.

Methods. Forty-eight hypertensive renal transplant recipients on a stable dose of CsA were randomized in a double-blind, parallel-group manner to receive either amlodipine (n = 24) or tertatolol (n = 24) for 60 days. The primary outcome measure was the change from baseline in serum uric acid concentration. Secondary analyses of efficacy were based on changes in renal function and blood pressure.

Results. Amlodipine significantly decreased serum uric acid levels from 483 ± 99 to 431 ± 110 μmol/l (P < 0.001), while tertatolol significantly increased uric acid from 450 ± 98 to 476 ±84 μmol/l (P = 0.006). Amlodipine also significantly increased glomerular filtration rate (P = 0.0048) and the clearance rate of uric acid (P = 0.023) and it reduced the fractional proximal tubular reabsorption of sodium (P < 0.001), compared with tertatolol. Renal plasma flow and filtered fraction were unaffected by both treatments, as was trough CsA blood concentration. Amlodipine lowered systolic blood pressure to a significantly greater extent than did tertatolol (P = 0.007). The time-dependent profile of diastolic blood pressure did not differ significantly between treatment groups. Both drugs were well tolerated.

Conclusions. Amlodipine could be more appropriate than tertatolol for CsA-induced hypertension and hyperuricaemia in renal transplant recipients.

Keywords: amlodipine; calcium channel blockade; cyclosporin A; gout; hyperuricaemia; renal transplantation

Journal Article.  3911 words.  Illustrated.

Subjects: Nephrology

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