VOL. 3, No. 2, April 2006

N. R. Robles [2006] Med Hypotheses Res 3: 709-725.

Calcium Antagonists and Renal Failure: New Properties
for New Generations

Nicolás Roberto Robles*

Servicio de Nefrología, Hospital Infanta Cristina, Badajoz, Spain

Abstract. Calcium antagonists are first-line antihypertensive agents but their effects in
patients with chronic renal diseases have not been clearly defined. The available information
concerning the renoprotective effects of calcium antagonists is complex in view of the
conflicting data coming out of various clinical trials. Based on a critical review of the
available literature, some conclusions are drawn here. (i) Use of calcium antagonists in
hypertensive patients with renal disease is safe and has no deleterious effects on renal
functions. (ii) Calcium antagonists may be better than diuretics and β-blockers to protect
renal function against hypertension. (iii) Renin-angiotensin axis-blocking agents are more
effective than calcium channel blockers to reduce proteinuria and to prevent renal disease
progression. (iv) The combination of calcium antagonists and renin-angiotensin axis-
blocking agents may be beneficial to improve renal protective effects of ACE inhibitors or
angiotensin receptors blockers when administered singly. (v) As suggested in some recent
reports, the new-generation calcium antagonists, which have the property of vasodilator
action on both afferent and efferent glomerular arterioles, may have interesting renal
protective effects. More clinical studies will be needed to confirm this possible beneficial

*Address all correspondence to: Dr. Nicolás Roberto Robles, Servicio de
Nefrología, Hospital Infanta Cristina, Carretera de Portugal s/n. 06070, Badajoz, Spain.

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