Which antihypertensive drugs should be taken for kidney disease: scientific choices and precautions
In recent years, the incidence of chronic kidney disease (CKD) combined with hypertension has increased year by year, and how to choose appropriate antihypertensive drugs has become the focus of patients' attention. This article combines hot topics and clinical guidelines across the Internet in the past 10 days to provide patients with kidney disease with suggestions on the reasonable selection of antihypertensive drugs.
1. The relationship between kidney disease and hypertension
Hypertension is both a common complication of kidney disease and a risk factor that accelerates the deterioration of kidney function. Controlling blood pressure can delay the progression of kidney disease, but attention should be paid to the effects of drugs on the kidneys.
2. Selection of antihypertensive drugs for patients with kidney disease
According to the 2023 "China Guidelines for the Prevention and Treatment of Hypertension" and KDIGO clinical practice recommendations, patients with kidney disease need to give priority to drugs with renal protective effects to reduce blood pressure. The following are the classification and characteristics of common antihypertensive drugs:
| drug type | Representative medicine | Applicable people | Things to note |
|---|---|---|---|
| ACEI (angiotensin-converting enzyme inhibitor) | benazepril, fosinopril | proteinuria patients | Monitor serum potassium and kidney function |
| ARB (angiotensin receptor blocker) | Valsartan, Losartan | ACEI intolerant people | Avoid use with ACEI |
| CCB (calcium channel blocker) | Amlodipine, nifedipine | People with moderate to severe renal insufficiency | No absolute taboos |
| diuretics | Furosemide, hydrochlorothiazide | Edema or volume overload | Be wary of electrolyte imbalances |
3. Answers to popular questions
1.Will ACEI/ARB damage the kidneys?
Rational use can protect the kidneys, but creatinine and serum potassium need to be monitored regularly. If creatinine rises >30% after taking the drug, the dose needs to be adjusted.
2.How to choose medicine for patients with renal failure?
When GFR is less than 30 ml/min, CCB or ARB is preferred, and thiazide diuretics should be used with caution.
4. Life management suggestions
In addition to drug treatment, you also need to pay attention to:
5. Latest research trends
A 2024 study published in "Nature Reviews Nephrology" pointed out that SGLT-2 inhibitors (such as dapagliflozin) can significantly reduce cardiovascular risks in patients with kidney disease while lowering blood pressure, but it should be noted that they may increase the risk of urinary tract infections.
Summary
The choice of antihypertensive drugs for patients with kidney disease needs to be individualized, giving priority to ACEI/ARB drugs, and closely cooperating with doctors to monitor renal function. Scientific medication combined with lifestyle intervention can effectively delay disease progression.
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