Medicines to manage kidney disease
The previous
article, elaborated on the fact that there is no specific drug to
treat kidney disease and that managing or preventing
health problems can stop
kidney damage from getting worse. Accordingly, to
manage the health problems
that lead to kidney disease, proper medication
should be taken with precautions
for each health problem. In this article, we present how to take proper
medicines along with precautions for some more such health problems.
High blood pressure and kidney disease
Blood pressure is the force of blood pushing against the walls of blood
vessels when the human heart pumps blood. High blood pressure is an increase
in the force exerted by the blood on the blood vessels as it moves through the
body. Healthy kidneys filter about half a cup of blood every minute, removing
waste and extra water for urination. High blood pressure constricts and
narrows blood vessels. Blood flow decreases due to narrowing. Because of
this, it eventually damages the whole body including the kidneys. Damage to
the blood vessels in the kidneys can cause them to no longer function properly.
Then the kidneys are unable to remove waste and extra fluid from the body.
Because of this, the extra fluid in the blood vessels can further increase
blood pressure, which can eventually lead to kidney failure.
According to that, by taking the right medicine for high blood pressure
and lowering the blood pressure, the development of kidney disease can be
significantly
reduced. Several blood pressure-lowering medications slow the
Eg:
- Benazepril (Lotensin)
- Captopril
- Enalapril (Vasotec)
- Fosinopril
- Lisinopril (Prinivil, Zestril)
- Moexipril
- Perindopril
- Quinapril (Accupril)
- Ramipril (Altace)
- Trandolapril
after a heart attack. ARBs reduce the activity of the angiotensin II hormone.
The hormone angiotensin II has a powerful constricting effect on blood vessels,
increasing blood pressure. Angiotensin II also stimulates salt and water
retention and increases blood pressure. Accordingly, ARBs block the receptors
that angiotensin II acts on. AT1 receptors, in particular, are found in the heart,
blood vessels, and kidneys. Blocking the action of angiotensin II helps lower
blood pressure and prevent damage to the heart and kidneys.
Eg:
- Atacand (candesartan)
- Avapro (irbesartan)
- Benicar (olmesartan)
- Cozaar (losartan)
- Diovan (valsartan)
- Micardis (telmisartan)
- Teveten (eprosartan)
medication that lowers
blood pressure. Beta-blockers block the effects of the
hormone epinephrine, also known as adrenaline. Furthermore Beta-blockers
lower blood pressure by making the heart beat more slowly and with less force.
Moreover, it also
helps to dilate veins and arteries to improve blood flow. Beta-
blockers are not
recommended as first-line treatment for people with high blood
pressure. Also, a doctor may prescribe a beta blocker as one of several
medications to lower blood pressure.
Eg:
- Acebutolol
- Atenolol (Tenormin)
- Bisoprolol (Zebeta)
- Metoprolol (Lopressor, Toprol XL)
- Nadolol (Corgard)
- Nebivolol (Bystolic)
- Propranolol (Inderal, InnoPran XL)
remove water from the blood. It also reduces the amount of fluid flowing
through the veins and arteries. Finally lowers blood pressure. Diuretics are also
used to prevent, treat, or improve symptoms in people with certain kidney
problems, such as heart failure, liver failure, tissue swelling, and kidney stones.
There are three types of diuretics: Thiazide, Loop, and Potassium-sparing
are among them. Each type of diuretic affects
different parts of the kidney.
Sometimes a diuretic is combined with a blood pressure medication. Which
type of diuretic is best depends on your health and the condition being treated.
Thiazide diuretics are recommended as first-line drug therapy for
hypertension. Thiazide refers to both a sulfur-containing organic molecule and a
group of diuretics based on the chemical structure of benzothiadiazole. Thiazide
diuretics are primarily used to treat high blood pressure and edema caused by
excess water, as well as certain conditions associated with imbalanced calcium
metabolism.
Eg:
- Chlorothiazide
- Chlorthalidone
- Hydrochlorothiazide
- Indapamide
- Metolazone
Diuretics that act on the Na-K-Cl cotransporter along the thick ascending
limb of the loop of Henle in the kidney are called loop diuretics. They are
primarily used in medicine to treat high blood pressure and edema due to heart
failure or chronic kidney disease. Thiazide diuretics are more effective in
patients with normal renal function, while loop diuretics are more effective in
patients with impaired renal function.
Eg:
- Bumetanide (Bumex)
- Ethacrynic acid (Edecrin)
- Furosemide (Lasix)
- Torsemide (Soaanz)
Potassium-sparing diuretics are drugs that cause diuresis without loss of
potassium in the urine. They are commonly used as an adjunct in the
management of hypertension, cirrhosis, and heart failure. Steroid aldosterone
antagonists are also used to treat primary hyperaldosteronism. Spironolactone,
a steroidal aldosterone antagonist is used to manage female hirsutism and
acne due to PCOS or other causes.
Eg:
- Amiloride (Midamor)
- Eplerenone (Inspra)
- Spironolactone (Aldactone, Carospir)
- Triamterene (Dyrenium)
Many medications are available to control high blood pressure. However,
some of these drugs can cause problems with your kidneys. Therefore,
remember to consult a doctor about the most suitable medicines. Also, you
should keep in mind that by taking proper medication and controlling
your blood pressure, you can reduce or control the complications that occur
in your kidneys.
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