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document
Calcium channel blocker inhibition of AGE and RAGE axis limits renal injury in nondiabetic patients with stage I or II chronic kidney disease . BACKGROUND There is a growing body of evidence that advanced glycation end products ( AGE ) and their receptor ( RAGE ) system are implicated in chronic kidney disease ( CKD ) . We have previously found that a long-acting calcium channel blocker , azelnidipine , but not amlodipine , improves renal injury in CKD patients . However , little is known about the effect of azelnidipine on the AGE-RAGE axis in humans . In this study , we examined whether azelnidipine addition could have renoprotective properties in hypertensive CKD patients by reducing serum levels of AGE and soluble form of RAGE ( sRAGE ) . Thirty nondiabetic stage I or II CKD patients who had already been treated with angiotensin II receptor blockers were enrolled in this study . HYPOTHESIS We hypothesized that azelnidipine treatment could limit renal injury partly by blocking the AGE-RAGE axis . METHODS Patients were randomly divided into 2 groups ; one group was treated with 16 mg azelnidipine and the other with 5 mg amlodipine once daily . They were followed up for 6 months . RESULTS Proteinuria was positively correlated with circulating AGE and sRAGE levels in our subjects . Both drugs exhibited comparable and significant blood pressure ( BP ) -lowering effects . Although neither of them affected glucose , glycated hemoglobin , lipid levels , and estimated glomerular filtration rate , treatment with azelnidipine , but not amlodipine , decreased circulating AGE , sRAGE , proteinuria , and urinary levels of liver-type fatty acid binding protein , a marker of tubular injury , in a BP-lowering-independent manner . CONCLUSIONS Our present results suggest that azelnidipine may exert renoprotective properties in nondiabetic hypertensive CKD patients via its unique inhibitory effects on the AGE-RAGE axis .
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Intervention_Pharmacological
AGE
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Intervention_Pharmacological
RAGE
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Intervention_Pharmacological
calcium channel blocker , azelnidipine , but not amlodipine
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Intervention_Pharmacological
azelnidipine
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Intervention_Pharmacological
azelnidipine
49767
Intervention_Pharmacological
azelnidipine
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Intervention_Pharmacological
azelnidipine
49769
Intervention_Pharmacological
amlodipine
49770
Intervention_Pharmacological
azelnidipine
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Intervention_Pharmacological
amlodipine
49772
Intervention_Pharmacological
azelnidipine
49773
Outcome_Physical
renal injury
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Outcome_Physical
renal injury
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Outcome_Physical
AGE-RAGE axis
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Outcome_Physical
serum levels of AGE and soluble form of RAGE ( sRAGE )
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Outcome_Physical
AGE-RAGE axis
49778
Outcome_Physical
Proteinuria
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Outcome_Physical
circulating AGE and sRAGE levels
49780
Outcome_Physical
blood pressure ( BP ) -lowering effects
49781
Outcome_Physical
glucose , glycated hemoglobin , lipid levels , and estimated glomerular filtration rate , treatment with azelnidipine
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Outcome_Physical
circulating AGE , sRAGE , proteinuria , and urinary levels of liver-type fatty acid binding protein
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Outcome_Physical
renoprotective properties
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Participant_Condition
nondiabetic
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Participant_Condition
stage I or II chronic kidney disease
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Participant_Sample-size
Thirty
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Participant_Condition
nondiabetic stage I or II CKD patients
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Participant_Condition
nondiabetic hypertensive CKD patients