The effect of vasodilator β-blockers on renal function in hypertensive patients

Lawrence H. Kwon, Karan Wats, Clive Rosendorff

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Background: Not only is there a limited number of studies on the effects of vasodilator β-blocker (VBB) therapy on kidney function-specifically, glomerular filtration rate (GFR), serum creatinine (sCr) and proteinuria-but of those that have been reported, the results are mixed. This meta-Analysis seeks to assess the efficacy of VBBs on selected renal parameters in hypertensive patients. Methods: We conducted a meta-Analysis of any prospective trial that provided both baseline and follow-up of at least 4 weeks of VBB therapy-carvedilol, labetalol, dilevalol, nebivolol and celiprolol in patients with hypertension. We used Ovid MEDLINE, EMBASE and PubMed, all without date restrictions. We included 39 studies totaling 3987 patients. Results: Although VBBs did not significantly change GFR or sCr levels after at least 4 weeks of therapy, they did significantly decrease protein excretion by-0.12 SD units [95% confidence interval (CI)-0.19 to-0.04; P < 0.01]. VBBs did not alter renal blood or plasma flow, but renal vascular resistance (RVR) decreased by-20.03 mmHg min/l (95% CI-28.92 to-11.15; P < 0.01). In the analysis which compared VBBs with non-VBBs, the only significant difference was the greater decrease in RVR in the VBB group by-38.44 mmHg min/l (95% CI-60.57 to-16.31; P < 0.01). Conclusion: VBBs do not affect GFR or sCr levels, but decrease protein excretion. This class of β-blockers, however, is not superior to non-VBBs in reducing proteinuria. VBBs decrease RVR significantly more than non-VBBs.

Original languageEnglish
Pages (from-to)1768-1777
Number of pages10
JournalJournal of Hypertension
Volume35
Issue number9
DOIs
StatePublished - 1 Sep 2017

Keywords

  • carvedilol
  • celiprolol
  • glomerular filtration rate
  • hypertension
  • labetalol
  • nebivolol
  • renal blood flow
  • renal function
  • renal hemodynamics
  • renal vascular resistance
  • serum creatinine
  • vasodilator β-blocker

Fingerprint

Dive into the research topics of 'The effect of vasodilator β-blockers on renal function in hypertensive patients'. Together they form a unique fingerprint.

Cite this