Effect of Dihydropyridine Calcium Channel Blockers (CCB) on the Progression of Diabetic Nephropathy in Aranyaprathet Hospital, Sakeaw Province, Thailand

Abstract

<i>Importance</i> From Thailand, has standardized therapeutic drugs of Calcium channel blockers (CCB) in reduce the progression of chronic renal failure in diabetic and hypertension that is advantages for use in patients. However, use of Amlodipine that is more accessible and also a drug used by all community hospitals to treat patients, inexpensive and highly effective.<i> Objective</i> To study effective of Dihydropyridine Calcium channel blockers (CCB) on kidney function (eGFR), urinary protein creatinine and sugar blood level. <i>Design, Setting, and Participants</i> This study is retrospective cohort study by study in patients with diabetic nephropathy. By study in patients with diabetes nephropathy with stage 3 or higher and receiving Dihydropyridine Calcium channel blockers (CCB). <i>Exposures</i> Dihydropyridine Calcium channel blockers (CCB) in reducing the complications of diabetic nephropathy which is consistent with Strategy No.2 Providing quality and excellent health services. And literature reviews in Thailand have not found empirical evidence that mean Calcium Channel can reduce the complications of diabetic nephropathy. <i>Main Outcomes and Measures</i> The effectiveness of Dihydropyridine Calcium channel blockers (CCB) increases the complications of diabetic nephropathy. <i>Results</i> In volunteer, female patient proportion was 69.0%. Average age was 69.3 (± 9.69), minimum age is 40 years, maximum age is 97 years. Most patients were between 60-79 years, follow by 40-59 years follow by16.8% and more than 80 years 16.1%. In congenital disease, kidney disease, kidney failure, diabetes and hypertension are 100%, follow by 24% obesity and 0.2% cancer. The effect of Dihydropyridine Calcium channel blockers (CCB) on kidney function (eGFR), urine microalbumin and creatinine when compare with use drug CCB 2 groups including Amlodipine and Amlodipine+enalapril/losartan/valsartan. Found that volunteer that received CCB drug compare with month 3 and 12, the level of eGFR decreases (t=1.085) and Urine Microalbumin increases (t=1.496) by statistically significance (P = 0.002) and Dihydropyridine Calcium channel blockers (CCB) on Fasting blood sugar compares with month 3 and 12, Fasting blood sugar (t = 0.566) and HbA1C (t=0.677) was typically decreased significantly (P < 0.005). <i>Conclusions and Relevance</i> Calcium channel blockers (CCBs) was decline kidney function (decrease eGFR) and CCB leads to the decrease of eGFR and provides monitoring of CCB use, as this may lead to the decrease of kidney function.