TY - JOUR
T1 - The effect of vasodilator β-blockers on renal function in hypertensive patients
AU - Kwon, Lawrence H.
AU - Wats, Karan
AU - Rosendorff, Clive
N1 - Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - 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.
AB - 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.
KW - carvedilol
KW - celiprolol
KW - glomerular filtration rate
KW - hypertension
KW - labetalol
KW - nebivolol
KW - renal blood flow
KW - renal function
KW - renal hemodynamics
KW - renal vascular resistance
KW - serum creatinine
KW - vasodilator β-blocker
UR - http://www.scopus.com/inward/record.url?scp=85021272157&partnerID=8YFLogxK
U2 - 10.1097/HJH.0000000000001447
DO - 10.1097/HJH.0000000000001447
M3 - Review article
C2 - 28650912
AN - SCOPUS:85021272157
SN - 0263-6352
VL - 35
SP - 1768
EP - 1777
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 9
ER -