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Chronic Kidney Disease (cont.)

Chronic Kidney Disease Medications

  • Angiotensin converting enzyme inhibitors (ACE-Is): ACE-Is are drugs commonly used in the treatment of hypertension. Some examples of these drugs include captopril (Capoten), enalapril (Vasotec), lisinopril (Zestril, Prinivil), ramipril (Altace), quinapril (Accupril), benazepril (Lotensin) and trandolapril (Mavik). These drugs decrease blood pressure by reducing production of angiotensin-II (a hormone that causes blood vessels to constrict) and aldosterone (a hormone that causes sodium retention). Besides reducing blood pressure, these drugs have additional effects that affect progression of kidney disease including reducing pressure inside the glomerulus and decreasing scarring in the kidney.

  • Common adverse drug reactions include hypotension (low blood pressure), cough, hyperkalemia (high potassium), headache, dizziness, fatigue, nausea, skin rash and a metallic taste. In some patients, the medication may cause a further decline in kidney function. Rarely, patients may develop angioedema, which is swelling of the subcutaneous and submucosal tissue and may lead to difficulty in breathing. This may be a life-threatening condition and needs immediate medical attention.

  • Angiotensin receptor blockers (ARBs): ARBs are drugs that block the action of angiotensin 2 on its receptors. These drugs, like ACE-I, have a protective effect on the kidneys and slow the progression of kidney failure. Drugs included in this category include losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), candesartan (Atacand) and olmesartan (Benicar).

  • Common adverse drug reactions include dizziness, headache, and hyperkalemia. Other side effects include hypotension, rash, diarrhea, dyspepsia, abnormal liver function, muscle cramps, myalgia, back pain, insomnia, anemia, and worsening of kidney function. Instances of angioedema are also reported with ARBs.

  • Diuretics: The doctor may prescribe diuretics (water pills) to control edema (swelling), blood pressure and/or potassium levels. There are several classes of diuretics, including loop diuretics (furosemide, ethacrynic acid, bumetanide, torsemide), thiazides (hydrochlorothiazide, chlorthalidone, indapamide), and potassium-sparing diuretics (spironolactone, eplerenone, amiloride, triamterene). Diuretics differ in their potential to eliminate salt and water.

  • Common adverse effects include frequent urination, dehydration, muscle cramps, weakness, heart rhythm abnormalities, electrolyte abnormalities, lightheadedness, and allergic reactions. Diuretics may also cause a decline in kidney function especially if fluid is removed rapidly from the body.

Medically Reviewed by a Doctor on 9/13/2012
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Chronic kidney disease (CKD) is characterized by an irreversible deterioration of renal function that gradually progresses to end-stage renal disease (ESRD).

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