Antihypertensive and renal protection effects of lercanidipine and lercanidipine/enalapril

Systemic arterial hypertension is the second most common cause of end-stage kidney disease (ESKD). Renal protection activity has been demonstrated for angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), gliflozins (dapagliflozin ed empagliflozin) and by the third-generation calcium channel blockers (CCB). Lercanidipine, a third-generation calcium channel blocker, has been shown to have a unique pharmacological and clinical profile, which translates into favorable renal hemodynamic changes. Here we summarized the pharmacological properties of lercanidipine and evaluate its ability to reduce proteinuria and preserve renal function when used as monotherapy or in combination with the angiotensin-converting enzyme (ACE) inhibitor enalapril. The fixed-dose combination lercanidipine/enalapril showed an excellent pharmacological profile with demonstrated clinical efficacy and tolerability in high-risk patients. Lercanidipine can be considered the preferred choice among calcium channel blocker drugs for the treatment of hypertensive patients at risk of renal impairment.