Managing hypertension medications in people with chronic kidney disease

Kidney cartoon 3

 

Managing hypertension medications in people with chronic kidney disease:

  • ACE inhibitors (Angiotensin-converting enzyme inhibitor) or ARBs (Angiotensin II receptor blocker) are essential part of the best care approach for many patients in all stage chronic renal disease
  • They cause a reduction in glomerular blood flow, and GFR (Glomerular filtration rate) can decline when treatment is initiated
  • Providing the GFR reduction is less than 25% within two months of starting therapy, the ACE inhibitors or ARB should be continued
  • If the reduction in GFR is more than 25% below the baseline value, the ACE inhibitor or ARB should be ceased and consideration given to referral to a nephrologist
  • Combined therapy with ACE inhibitors and ARB should be avoided except with specialist advice
  • Caution should be exercised if baseline K+ is ≥5,5 mmol/L, as rises in serum. K+of approximately 0,5 mmol/L are expected
  • ACE inhibitors and ARBs  can be safely be prescribed at all stages chronic kidney disease and should not be deliberately avoided just because GFR is reduced
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About azaleaazelia

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4 Responses to Managing hypertension medications in people with chronic kidney disease

  1. vicklea says:

    So true! I had hypertension with problems mounting with my one kidney. I had to go to an endocrinologist to get the right medicine for my hypertension that would not exacerbate my kidney problem. A few years later I had a stroke, changed my diet and my kidney function improved. I’m not taking any meds for either now, three years after my stroke.

    Like

  2. Michael says:

    Thank you for such a great article!

    Like

  3. Michael says:

    Very nice article. Thanks a lot!

    Like

  4. Michael says:

    woowww. I found another article at https://www.madeformedical.com/nursing-care-plan-for-hypertension but your the one you wrote, is just awesome!

    Like

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