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Chronic Kidney Disease (cont.)

More Chronic Kidney Disease Medications

ESAs may have serious side effects. These include the risk of strokes, heart attacks, and blood clots. Worsening hypertension and seizures as well as serious allergic reactions are other side effects.

The calcium-based binders may cause hypercalcemia. Lanthanum and sevelamer do not contain calcium. While non-calcium based binders are much more expensive, the doctor may favor these if a patient's blood calcium levels are high. All phosphate binders may cause constipation, nausea, vomiting, bowel obstruction, and fecal impaction. Phosphate binders may interfere with the absorption of other medications if these are taken together. Always check with the doctor to confirm the suitability of taking these medications together with other drugs.

As kidney disease progresses, activated forms of vitamin D may be prescribed. These drugs include calcitriol (Rocaltrol), paricalcitol (Zemplar), or doxercalciferol (Hectorol). These drugs are prescribed to control secondary hyperparathyroidism when the correction of nutritional vitamin D deficiency, administration of calcium supplementation, and control of serum phosphate have been ineffective.

The use of activated vitamin D may cause hypercalcemia (high calcium levels). The symptoms of hypercalcemia include feeling tired, difficulty thinking clearly, loss of appetite, nausea, vomiting, constipation, increased thirst, increased urination, and weight loss. Other side effects include diarrhea, nausea, swelling, allergic reactions, viral infections, high blood pressure, inflammation of the throat and nose, and dizziness. The doctor will recommend regular blood tests to follow the patient's kidney function, calcium, phosphorus, and parathyroid hormone levels.

  • Erythropoiesis-stimulating agents (ESAs): Patients with chronic kidney disease often develop anemia due to a lack of erythropoietin produced by the kidneys. Anemia is a condition with too few red cells and is characterized by fatigue and tiredness. After excluding other causes of anemia, the doctor may prescribe erythropoiesis-stimulating agents (ESAs) such as Procrit (erythropoietin), Aranesp (darbepoetin), or Omontys (peginesatide). ESAs stimulate the bone marrow to produce red cells and reduce the need for blood transfusions.

  • Phosphate binders: The doctor may recommend a diet low in phosphorus if one's serum phosphorus levels are high. If dietary restriction of phosphorus is unable to control the phosphorus levels, the patient may be started on phosphate binders. When taken with meals, binders combine with dietary phosphate and allow for elimination without absorption into the bloodstream. Binders are divided into large classes, including calcium-based binders such as Tums (calcium carbonate) and PhosLo (calcium acetate) and non-calcium based binders like Fosrenol (lanthanum carbonate), Renagel (sevelamer hydrochloride) and Renvela (sevelamer carbonate).
  • Vitamin D: Vitamin D deficiency is very common in patients with chronic kidney disease. The first step in treating metabolic bone disease is to ensure that there are adequate reserves of vitamin D in the body. The doctor may prescribe over-the-counter vitamin D or prescription-strength vitamin D (Drisdol) based on the patient's vitamin D levels.
Last Reviewed 11/17/2017
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