anti-proteinuria

 Q: Which of the following group of drugs has the best anti-proteinuria effect? (select one)

A) calcium channel blockers 

B) beta-blockers 

C) diuretics 

D) alpha-1-blockers 

 E) methyldopa

Answer: A

Although ACE inhibitors and Angiotensin II receptor blockers (ARBs) are known as anti-proteinuria agents and are used as a standard in diabetic patients. In addition, non-dihydropyridine calcium channel blockers (diltiazem, verapamil) has a good antiproteinuric effect. 

Beta-blockers, diuretics, and alpha-1-blockers have some antiproteinuric effects but methyldopa has little effect on protein excretion.

#pharmacology

References:

1. Bakris GL, Weir MR, Secic M, et al. Differential effects of calcium antagonist subclasses on markers of nephropathy progression. Kidney Int 2004; 65:1991. 

2. Ruggenenti P, Perna A, Benini R, Remuzzi G. Effects of dihydropyridine calcium channel blockers, angiotensin-converting enzyme inhibition, and blood pressure control on chronic, nondiabetic nephropathies. Gruppo Italiano di Studi Epidemiologici in Nefrologia (GISEN). J Am Soc Nephrol 1998; 9:2096.

3. Gansevoort RT, Sluiter WJ, Hemmelder MH, et al. Antiproteinuric effect of blood-pressure-lowering agents: a meta-analysis of comparative trials. Nephrol Dial Transplant 1995; 10:1963.