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Up-to-date data on combination therapy of arterial hypertension in patients with chronic kidney disease are presented. Special attention is paid to the fixed combination of calcium antagonist lercanidipine and angiotensin-converting enzyme inhibitor enalapril.

About the Author

N. A. Dzhaiani
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
Russian Federation


1. Cardiovascular risk and chronic kidney disease: cardio nephroprotection strategy. National guidelines. Available at: by: 20.04.2013. Russian (Сердечно-сосудистый риск и хроническая болезнь почек: стратегии кардио-нефропротекции. Национальные рекомендации. Доступно на: Дата доступа: 20.04.2013).

2. Middleton RJ, Foley RN, Hegarty J, et al. The unrecognized prevalence of chronic kidney disease in diabetes. Nephrol Dial Transplant 2006;21:88-92.

3. Segura J, Garcia-Donair J, Praga M, et al. Chronic kidney disease as a situation of high added risk in hypertensive patients J Am Soc Nephrol 2006;17 (Suppl 2.):136-40.

4. K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients.Am J KidneyDis 2005;45 (Suppl 3):S1-153. 5. SarnakMJ, LeveyAS, SchoolwerthAC, et al.Kidney disease as a risk factorfor development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension 2003; 42: 1050-65.

5. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Stamler J. End-stage renal disease in AfricanAmerican and white men. 16-year MRFIT findings. JAMA 1997; 277:1293-8.

6. Chronic kidney disease: basic principles of screening, diagnosis, prevention and treatment approaches. National guidelines. Nephrology 2012; 16 (1): 89-115. Russian (Хроническая болезнь почек: основные принципы скрининга, диагностики, профилактики и подходы к лечению. Национальные рекомендации. Нефрология 2012; 16(1): 89-115).

7. National Kidney Foundation. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease.Am J Kidney Dis 2007: 49 (Suppl2):Sl-180.

8. Vassalotti JA, Stevens LA, Levey AS. Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007;50(2): 169-80.

9. Мое S, Drueke T, Cunningham J, et al. Kidney Disease: Improving Global Outcomes (KDIGO). Definition and classification of chronic kidney disease: a position statementfrom KidneyDisease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67: 2089-100.

10. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int (Suppl.) 2013;3:1-150.

11. Redon J. Renal protection by antihypertensive drugs. Insights from microalbuminuria studies. 17th Scientific Meeting of the International Society of Hypertension. Amsterdam, The Netherlands. 7-11 June 1998.

12. Epstein M, Tobe S. What is the optimal strategy to intensify blood pressure control and prevent progression of renal failure? Cur Hypertens Rep 2001; 3: 422-8.

13. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34:2159-219.

14. de Zeeuw D, Remuzzi G, ParvingHH, et al. Proteinuria, a target forrenoprotection in patients with type 2 diabetic nephropathy: Lessons from RENAAL. Kidney Int 2004;65: 2309-0.

15. Gruppo Italiano di Studi Epidemiologici in Nefrologia (GISEN). Randomised placebo-controlled trial of effect oframipril on decline in glomerularfiltration rate and risk ofterminalrenalfailure in proteinuric, non-diabetic nephropathy. Lancet 1997; 349: 1857-63.

16. Lewis EJ et al. Renoprotective effects of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 20 (345) 12: 851-60.

17. Parving HH et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 20 (345) 12: 870-8.

18. Shionoiri H, Yasuda G, Sugimoto K, et al. Effect of long-term therapy with an ACE inhibitor and a diuretic on microalbuminuria in essential hypertension. 17th Scientific Meeting of the International Society of Hypertension. Amsterdam, The Netherlands. 7-11 June 1998.

19. Opie LH, Messerly FH. CombinationDrug Therapy forHypertension. 1997. Philadelphia, NY: LippincottRaven Publishers; 1997.

20. Shabalin AV. Combined antihypertensive therapy: the state of achievement. Novosibirsk SPSTL; 2001. Russian (Шабалин А.В. Комбинированная антигипертензивная терапия: состояние, достижения. Новосибирск: ГПНТБ СО РАН; 2001).

21. Chazova IE, Ratova LG. Combination therapy of hypertension. Moscow: Media Medica; 2007. Russian (Чазова И.Е., Ратова Л.Г. Комбинированная терапия артериальной гипертонии. М.: Mеdia Medica; 2007).

22. Makolkin VI. The combination of ACE inhibitor and calcium antagonist highly effective. Russian Journal of Medicine, 2009; (8): 534-9. Russian (Маколкин В.И. Комбинация ингибитора ангиотензинпревращающего фермента и антагониста кальция высоко эффективна. Русский Медицинский Журнал 2009; (8): 534-9).

23. Weber MA, Bakris GL, Dahlof B et al. The Avoiding Cardiovascular events through Combination therapy in Patients Living with Systolic Hypertension). Вaseline characteristics in the Avoiding Cardiovascular events through Combination therapy in Patients Living with SystolicHypertension (ACCOMPLISH) trial: A Hypertensive population at high cаrdiovascular risk. Blood Pressure 2007; 16: 13-9.

24. Bakris GL, Sarafidis PA, Weir MR et al. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet 2010;375(9721):1173-81.

25. Pepine CJ.,Handberg-Thurmond E. Rationale and design ofthe International Verapamil SR/Trandolapril Study (INVEST): an internet0based randomized trial in coronary artery disease patients with hypertension. JACC 1998; 32: 1228-37.

26. Dahlof B, Sever PS, Poulter NR for the ASCOT investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required in theAnglo-Scandinaviam Cardiac Outcomes Trial – Blood-Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005; 366: 895-906.

27. Lundberg G.D. MRFIT and the goals of the journal. JAMA 1982; 248 (12):1501.

28. Holdaas H, Hartmann A, Berg K et al. Renal effects of losartan and amlodipine in hypertensive patients with non-diabetic nephropathy. Nephrol Dial Transplant 1998; 13: 3096-102.

29. Rodicio JL, Campo C, Ruilope LM. Renal effects of calcium antagonists. Nephrol Dial Transplant 1995; 10(Supp l): 17-22.

30. Rodicio JL, Ruilope LM. Assessing renal effects and renal protection. J Hypertens Suppl 1995; 13(4): S19-25.

31. Nakamura T, Sato E, Fujiwara N, et al. Calcium channel blocker inhibition of AGE and RAGE axis limits renal injury in nondiabetic patients with stage I orII chronic kidney disease. Clin Cardiol 2011; 34(6): 372-7.

32. Borghi С, Santi F. Fixed combination of lercanidipine and enalapril in the management of hypertension: focus on patient preference and adherence. Patient Prefer Adherence 2012; 6: 449-55.

33. Sabbatini M, Leonardi A, Testa R, et al. Effect of Calcium Antagonists on Glomerular Arterioles in Spontaneously Hypertensive Rats. Hypertension 2000; 35: 775-9.

34. Dalla Vestra M, Pozza G, Mosca A. et al. Effect of lercanidipine compared with ramipril on albumin excretion rate in hypertensive Type 2 diabetic patients with microalbuminuria: DIAL study (diabete, ipertensione, albuminuria, lercanidipina). Diabetes Nutr Metab 2004; 17 (5): 259-66.

35. Robles NR, Ocon J, Gomez CF, et al. Lercanidipine in Patients with Chronic Renal Failure: The ZAFRA study. Ren Fail 2005; 27 (1): 73-80.

36. Robles NR, Romero B, de Vinuesa EG, et al. Treatment of proteinuria with lercanidipine associated with rennin-angiotensin axis-blocking drugs. Ren Fail 2010; 32:192-7.

37. Angelico P, Guarneri L, Leonardi A, et al. Vascular-selective effect of lercanidipine and other 1,4-dihydropyridines in isolated rabbit tissues. J. Pharmacol 1999; 51: 709-14.

38. Ortiz M, Calcino G. Inferred Mortality Differences between Dihydropyridine Antihypertensives . Hypertension 2009; 53: 1116.

39. Borghi C, Prandin MG, Dormi A. The use of lercanidipine can improve the individual tolerability to dihydropyridine calcium blockers in hypertensive patients. J Hypertens 2000; 18: Suppl 2: S155.

40. Cafiero M, Giasi M. Long-term (12-month) treatment with lercanidipine in patients with mild to moderate hypertension. J Cardiovasc Pharmacol 1997; 29: Suppl 2: S45-9.

41. Marx A, Lichtenthal A, Milbredt C, et al. Effect of anthypertensive therapy with a new third generation calcium antagonist lercanidipine on patients with concomitant diseases. J Hypertens 2004; 22 Suppl 2: S236.

42. Lund-Johansen P, Stranden E, Helberg S, et al. Quantification of leg oedema in postmenopausal hypertensive patients treated with lercanidipine or amlodipine. J Hypertens 2003; 21: 1003-10.

43. Fogari R, Mugellini A, Corradi L, et al. Efficacy of lercanidipine vs losartan on left ventricular hypertrophy in hypertensive type 2 diabetic patients. J Hypertens 2000; 18 Suppl 2: S65.

44. SanchezA, Sayans R,Alvarez JL, et al. Left ventricular hypertrophy regression after a short antihypertensive treatment with lercanidipine vs. enalapril. Fourth European Meeting on Calcium Antagonists; 1999; Oct 27-29; Amsterdam.

45. Baryshnikova GA Chorbinskaya SA Stepanova II. Dihydropyridine calcium antagonists in the treatment of hypertension in women: focus on lercanidipine. Difficult Patient 2013; (11): 10-6. Russian (Барышникова Г.А., Чорбинская С.А., Степанова И.И. Дигидропиридиновые антагонисты кальция в лечении артериальной гипертонии у женщин: фокус на лерканидипин. Трудный Пациент 2013;(11): 10-6).

46. Bang L., Chapman T., Goa K. Lercanidipine — a review of its efficacy in management of hypertension. Drugs 2003; 22: 2449-72.

47. Nebieridze DV. Calcium antagonists in clinical practice: focus on the metabolic and vascular effects. Ration Pharmacother Cardiol 2007; 3 (2): 67-71. Russian (Небиеридзе Д.В. Антагонисты кальция в клинической практике: фокус на метаболические и сосудистые эффекты. Рациональная Фармакотерапия в Кардиологии 2007; 3(2): 67-71).

48. LithellH. Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism.Diabetes Care 1991; 14:203-9.

49. Berne C. Metabolic effects of ACE inhibitors. J Int Med 1991; 229 (suppl 2):119-25.

50. Ravid M, Brosh D, Levi Z, et al. Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus. A randomized, controlled trial. Ann Intern Med 1998;128:982-8.

51. Neaton JD, Grimm RH Jr, Prineas RJ et al. Treatment of Mild Hypertension Study (TOMHS) final results. J Am Med Assoc 1993; 270: 713-24.

52. Rump LC. Efficacy and tolerability of the fixed lercanidipine-enalapril combination in the treatment of patients with essential hypertension. Arzneimittelforschung 2010;60:124-30.

53. Quarti F, Seravalle G, Dell Oro R, et al. Effects of lercanidipine/enelapril combination on neurometabolic alterations in obese hypertensive subjects with High blood pressure. Cardiovasc Prev 2010;17 (3): 1120.

54. Agrawal R, Marx A, Haller H. Efficacy and safety of lercanidipine versus hydrochlorothiazide as add on to enalapril in diabetic populations with uncontrolled hypertension. J Hypertens 2006;24:18592.

55. Puig JG, Calvo C, Luurila O, et al. Lercanidipine, enalapril and their combination in the treatment of elderly hypertensive patients: placebo-controlled,randomized, crossover study with four ABPM.JHum Hypertens 2007;21:917-24.

56. Scholze J, Bramlage P, Trenkwalder P, Kreutz R. Efficacy and safety of a fixed-dosecombination of lercanidipine and enalapril in daily practice. A comparison of office, self-measured and ambulatory blood pressure. Expert Opin Pharmacother 2011; 12(17): 1-9.


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