Johoku-Cilnidipine trial of renal function and blood pressure for clinical evaluation. - Johoku-Cilnidipine trial of renal function and blood pressure for clinical evaluation.(J-CIRCLE)

This study assessed the urinary albumin/creatinine ratio and uric acid metabolism in 70 hypertensive patients with CKD in whom the urinary albumin/creatinine ratio had remained  30 mg/g under the treatment of L-type calcium channel blocker amlodipine. Three months after switching to N/L-type calcium channel blocker cilnidipine, blood pressure did not change. However, urinary albumin/creatinine ratio significantly decreased by cilnidipine. Serum uric acid levels showed no significant change. In cases where uric acid production had been high (urinary uric acid/creatinine ratio  0.5), the urinary uric acid/creatinine ratio decreased significantly after cilnidipine treatment, suggesting that cilnidipine can suppress excessive uric acid formation. These results suggest that switching from amlodipine to cilnidipine resulted in a significant reduction in urinary albumin/creatinine ratio as well as significant reduction in uric acid production. Thus cilnidipine is more useful than amlodipine in improving albuminuria and uric acid metabolism in hypertensive patients with CKD.