Efficacy of Cilnidipine in Chronic Kidney Disease Patients with Respect to Blood Pressure, Proteinuria and Glomerular Filtration Rate

BACKGROUND: A high percentage of patients with early stages of CKD end up in cardiovascular and cerebrovascular consequences even before they progress to the advanced stages of CKD. Even a minor decline in GFR or the presence of micro albuminuria is now recognized as a major risk factor for cardiovascular disease. Hence in this study we have analyzed the effect of Cilnidipine in chronic kidney disease patients with respect to variation on blood pressure, proteinuria and glomerular filtration rate. AIM OF THE STUDY: To assess the effect of Cilnidipine in chronic kidney disease patients with respect to blood pressure, proteinuria and glomerular filtration. OBJECTIVES: 1. To monitor blood pressure response, assess proteinuria and measure glomerular filtration rate in CKD patients who are on Cilnidipine over a period of 3 months. 2. To correlate the level of blood pressure with proteinuria and estimated GFR. MATERIALS AND METHODS: This study was a prospective observational study, conducted at the Nephrology OPD, Department of Nephrology, Sree Mookambika Institute of Medical Sciences, Kulashekaram, Kanyakumari District, Tamil Nadu, during the period of February 2018 to February 2019 on chronic kidney disease patients,who satisfy the inclusion criteria after getting informed consent .The effects of Cilnidipine on blood pressure, proteinuria, glomerular filtration rate in CKD patients were entered in the prescribed case record form at 0, 1 and 3 months. Prescriptions of 48 CKD patients were examined. Statistical analysis were done using Fisher’s exact test, ANOVA, Tukey post hoc test, Pearson or Spearman’s correlation test. RESULTS: From our study findings we were able to conclude that systolic blood pressure after treatment with cilnidipine 20mg showed a decrease from the baseline with a statistically significant p value of <0.0001. The diastolic blood pressure after treatment with cilnidipine 20mg for 3months showed a statistically significant decrease from the baseline with a p value of <0.0039. The UPCR values after treatment with cilnidipine 10mg and 20mg did show a decrease from the baseline. But it was not statistically significant. The eGFR after treatment with cilnidipine 10mg and 20mg did show a marginal improvement from the baseline values. But it was also not statistically significant. This effect of cilnidipine reflected on serum creatinine which showed a mild decrease from the baseline values. But again it was not statistically significant. CONCLUSION: We conclude that cilnidipine has good antihypertensive efficacy, while antiproteinuric and renoprotective effects were clinically significant but statistically insignificant.