Expert Perspectives on the use of Cilnidipine in Hypertensive Patients with Diabetic Kidney Disease in Indian Settings

Objective: To assess clinicians' preferences and perceptions regarding the use of cilnidipine, both as monotherapy and in combination with telmisartan, for managing hypertension in patients with diabetic kidney disease (DKD) in Indian settings. Methodology:The cross-sectional study was conducted using a structured 23-item, multiple-response questionnaire designed to capture the perspectives of clinicians involved in the management of hypertension in patients with DKD.The questionnaire focused on current prescribing practices, clinical observations, treatment preferences, and experiences related tocilnidipine both as mono and combination therapy.Data were analyzed using descriptive statistics, and categorical variables were summarized as percentages to highlight prevailing trends and patterns in clinical practice. Results:The study was conducted among 601 clinicians and revealed that approximately 96% preferred cilnidipine as the calcium channel blocker of choice for patients with hypertension and DKD.Approximately half (50.08%) reported using cilnidipine as a first-line therapy in 21% to 30% of such patients, while 47% used it in 11% to 20% of cases.Most respondents (67.39%) agreed with the RSSDI guideline recommending cilnidipine in combination with angiotensin receptor blockers (ARBs) for enhanced cardiovascular and renal protection.Specifically, 83% favored telmisartan as the ARB of choice in this combination, and 55% reported that 11% to 20% of their patients were on a single-pill cilnidipine-telmisartan regimen.About 66% noted benefits of cilnidipine beyond blood pressure control, including reduced pedal edema, renal protection, and fewer cardiovascular events.Additionally, 47% observed a reduction in microalbuminuria in 26% to 50% of their patients.Around 39% commonly prescribed the cilnidipine-telmisartan single-pill combination for patients with uncontrolled hypertension and diabetes. Conclusion:Cilnidipine, alone or combined with telmisartan, is widely preferred by Indian clinicians for managing hypertension in patients with DKD, due to its additional benefits beyond BP control, including reno-protection and CV risk reduction. MethodologyWe carried out a cross-sectional study among experts managing hypertensive patients with DKD in Indian clinical settings from June 2024 to December 2024.