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HomeExclusiveWhich Blood Pressure Medicine Is Best For Kidney Disease

Which Blood Pressure Medicine Is Best For Kidney Disease

What Are The Clinical Signs Of High Blood Pressure In Cats

Vlog5: High Blood pressure with Kidney Failure and amlodipine minimal side effects

Abnormalities with vision are the most common clinical findings with feline hypertension. These abnormalities can include dilated pupils that do not constrict with light, blood within the chamber of the eye, and blindness. Blindness develops because high blood pressure in the eye causes the retina to detach. Blindness is usually noticed when the cat keeps bumping into objects in their path.

In some cases, hypertension is suspected because of a heart murmur or liver- or kidney-related clinical signs such as increased water intake or urination, vomiting, and weight loss. Other signs can include seizures, fainting episodes, or nose bleeds.

Are Certain Cats More Likely To Get High Blood Pressure

In humans, hypertension is related to several factors, including a stressful lifestyle. Although not all causes of feline hypertension have been identified, stress does not appear to play a role in the development of this disorder in cats.

“Hypertension is more common in older cats, especially overweight or obese cats.”

However, kidney, thyroid, and heart disease are the most common causes of feline hypertension and will be described in detail. Hypertension is more common in older cats, especially overweight or obese cats.

Do Dietary Supplements Help

It is highly questionable whether over-the-counter dietary supplements can help people with chronic kidney disease. For instance, it has been proven that antioxidants such as vitamin E supplements can neither increase life expectancy in people with chronic kidney disease nor prevent complications like heart attacks or strokes. There is also no proof that these medications can slow down the progression of the disease or help in certain people . This is true for fish oil and omega-3 fatty acid supplements, too.

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Classification Of Severity And Monitoring Of Disease Progression

The GFR is used to assess the degree of kidney-function impairment and to monitor disease progression and treatment response. GFR is a measure of the overall filtration rate of all nephrons. In persons 30 years or younger, the normal GFR is approximately 125 mL per minute per 1.73 m2 after the age of 30 years, GFR declines by 1 mL per minute per 1.73 m2 per year.

Estimation of the GFR no longer requires a 24-hour urine collection for creatinine clearance but can be accomplished with similar accuracy using a mathematic formula.1 The most commonly used formulas for estimating GFR in patients with stable chronic kidney disease are the Modification of Diet in Renal Disease equation and the Cockcroft-Gault equation .68

Equations for Predicting GFR in Patients with Stable Chronic Kidney Disease*

GFR = glomerular filtration rate MDRD = Modification of Diet in Renal Disease SCr = serum creatinine concentration CCr = creatinine clearance.

*For each equation, SCr is in mg per dL, age is in years, and weight is in kg.

The MDRD study equation is available in computer programs that calculate the result when patient data are entered.

Information from references 6 through 8.

Equations for Predicting GFR in Patients with Stable Chronic Kidney Disease*

GFR = glomerular filtration rate MDRD = Modification of Diet in Renal Disease SCr = serum creatinine concentration CCr = creatinine clearance.

Information from references 6 through 8.

Stages of Chronic Kidney Disease

Commonly Prescribed Medications For Chronic Kidney Disease

#Kidney Failure: Stages and Treatments

By MatheaW

There are many ways that chronic kidney disease is treated. One of the most common prescribed treatments for chronic kidney disease are dietary restrictions, but medications are also commonly prescribed. It can be difficult to find much information on medications used to treat chronic kidney disease. This is because there technically isnt a medication designed to treat kidney damage itself, as damage cannot actually be repaired. Instead, medications are used to control common symptoms and contributing disorders associated with chronic kidney disease.

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Is Surgery Necessary To Treat Renal Hypertension

If the condition does not improve with medication and/or angioplasty, or the narrowing recurs or cannot be stented for any reason, renal bypass surgery may be an option. By taking a vein or synthetic tube to connect your kidney to your aorta, the surgeon creates an alternate route, or bypass, for blood to flow around the blocked artery into your kidney. This procedure is complex and high risk and rarely used.

Managing Hypertension Following Kidney Transplantation

As in haemodialysis, there are currently no randomised clinical trials exploring how best to manage hypertension following kidney transplantation. Hypertension is common post-transplant, with multiple factors contributing to its development . More than 90% of recipients of a kidney transplant receiving a calcineurin inhibitor -based immunosuppression regimen will be hypertensive post-transplant . BP is also more likely to be uncontrolled, with~50% failing to achieve a systolic BP< 140 mmHg at 1 year . Higher BP is associated with poorer graft outcomes and greater CVD risk, which is the leading cause of death following kidney transplant . A retrospective study of 1666 kidney transplant recipients demonstrated a~5% increased risk of graft failure and death with every 10 mmHg rise in systolic BP . Broader cardioprotection including lipid-lowering and antiplatelet therapy is likely to be beneficial in most patients .

Factors contributing to the development of hypertension following kidney transplantation

CNIs such as tacrolimus, which form the mainstay of post-transplant immunosuppression, cause afferent arteriolar vasoconstriction. There is some evidence to suggest that dihydropyridine CCBs confer particular benefit in those treated with CNIs due to their ability to cause afferent arteriolar vasodilatation in this context . Non-dihydropyridine CCBs interfere with CNI metabolism, necessitating closer monitoring of drug levels .

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Baseline Characteristics Of The Study Population

The study included 22,278 participants . Among them, 12,174 were non-users and 10,104 were users of antihypertensive medications. The baseline characteristics of the total population and those of users and non-users of antihypertensive medications are summarised . The mean age of the participants was 63.3 years, and 48.6% of these participants were men. The mean estimated glomerular filtration rate was 41.7 ml/min/1.73 m2 for the total population, and 5.9% of the population showed urine dipstick positivity for protein. The mean age, proportion of women, proportion of individuals with low-income status, prevalence of dyslipidaemia and diabetes mellitus , and eGFR were higher among the users than among the non-users.

Figure 1

Medications For High Blood Pressure

Are there medications for kidney disease?

High blood pressure is directly and strongly related to chronic kidney disease. High blood pressure is a common cause of kidney damage, and chronic kidney disease is sometimes a cause of high blood pressure. It is very common for high blood pressure medications to be prescribed for the treatment of chronic kidney disease.

ACE Inhibitors, Beta Blockers, Vasodilators, and many more common high blood pressure medications are quite often prescribed to chronic kidney disease patients. More often than not, more than one medication is necessary to find the right balance for individual patients. There is no one size fits all answer to high blood pressure or chronic kidney disease, after all.

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How Common Are High Blood Pressure And Kidney Disease

Almost 1 in 2 U.S. adultsor about 108 million peoplehave high blood pressure.1

More than 1 in 7 U.S. adultsor about 37 million peoplemay have chronic kidney disease .2

High blood pressure is the second leading cause of kidney failure in the United States after diabetes, as illustrated in Figure 1.2

Almost 1 in 2 U.S. adultsor about 108 million peoplehave high blood pressure.

What Blood Pressure Medication Is Best For First Time

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Which High Blood Pressure Medication Is Best

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What Can I Do To Help Control My High Blood Pressure

Kidney Disease, Intensive Hypertension Treatment, and Risk ...

A healthy lifestyle is key to helping control any type of hypertension. Making changes in daily habits can help, such as:

  • Eating a heart-healthy diet: Choose fruits, vegetables, grains and low-fat dairy foods.
  • Exercising regularly, at least 30 minutes a day of moderate activity, such as walking .
  • Keeping your weight under control: Check with your healthcare provider for a weight-loss program, if needed.
  • Quitting smoking, if you smoke.
  • Cutting back on alcoholic drinks.
  • Limiting caffeine intake.
  • Limiting sodium in your diet: Read nutrition labels on packaged foods to learn how much sodium is in one serving.
  • Reducing and avoiding stress when possible: Many people find that regular meditation or yoga helps.

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How Is High Blood Pressure Diagnosed

Hypertension should be considered possible in any older cat with kidney disease or hyperthyroidism. Onset of sudden, unexplained blindness should raise a strong suspicion for hypertension, and the associated diseases should be considered. The presence of a heart murmur may also signal the presence of a hypertensive state.

“Standard blood pressure equipment used on humans will not work on cats.”

Blood pressure is measured with a device that can detect blood flow in arteries. Obviously, the cat has very small arteries when compared to those of humans. Consequently, the standard blood pressure equipment used on humans will not work on cats. Your veterinarian will discuss with you the simple blood pressure measurement protocol they recommend for your cat.

Are There Medicines That Can Help

Many people need medicine to control high blood pressure. Two groups of medications called ACE inhibitors and ARBs lower blood pressure and have an added protective effect on the kidney in people with diabetes. Additional studies have shown that ACE inhibitors and ARBs also reduce proteinuria and slow the progression of kidney damage in people who do not have diabetes. You may need to take a combination of two or more blood pressure medicines to stay below 130/80. Your doctor may also prescribe a diuretic in addition to your ACE inhibitor or ARB. Diuretics are also called “water pills” because they help you urinate and get rid of excess fluid in your body.

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Suggested Initial Prescribing Algorithm

Kidney Disease Treatment: Prevent CKD progression with blood pressure control

Notably, with the availability of new oral potassium exchange compounds patiromer and potentially, zirconium cyclosilicate, there is renewed interest in using these drugs to prevent hyperkalemia and permit prescription of ACEi, ARB, and MRB drugs in the setting of CKD. In contrast, we are of the opinion that aggressive use of inexpensive thiazide-like and loop diuretics alone or in combination can often control and prevent hyperkalemia and may preclude the need of more expensive, newer potassium exchange drugs. We acknowledge that definitive trials comparing the two approaches are lacking.

When resorting to pharmacotherapy for hypertension on HD, in the absence of specific indications for other drugs, we prescribe atenolol as first-line therapy on the basis of the results of the HDPAL Trial . For second-line therapy, we use dihydropyridines. We use ACEis or ARBs as our third-line choice. Although the early studies suggesting that MRBs reduce cardiovascular mortality in ESKD are promising , because of the risk of hyperkalemia, we do not prescribe MRBs routinely and await larger and more definitive studies.

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Comorbidities And Lower Blood Pressure

Dr. Nally and his colleagues used data from the Ohio Department of Health mortality files and classified deaths into three categories: cardiovascular, malignancy-related and noncardiovascular-/nonmalignancy-related.

Subjects had eGFR 15-59 ml/min/1.73 m2 with underlying hypertension and were prescribed at least one antihypertensive agent. Researchers identified 45,412 patients with this profile and found that over four years, 13,332 had died.

Data showed that patients with systolic blood pressures under 100, 100-109, 110-119, and over 150 were associated with higher all-cause and cardiovascular mortality.

Since we had a complete data set, we were able examine comorbidities, Dr. Nally adds. We found those with CKD plus heart failure, liver disease or diabetes, had an increased chance of death with pressures at 110 compared with people who had the same comorbidities and blood pressure at 130.

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Medications And Vitamins To Avoid With Ckd

There are certain medications that may need to be avoided or adjusted when youre living with chronic kidney disease. With CKD, your kidneys may not be able to filter some medications or vitamins from your blood, which can cause a harmful buildup of those substances in your body.

If you are taking any of the following medications, talk to your doctor about how they work with kidney disease. Your doctor may adjust your dosage or change your medication entirely.

  • Statins may require a dosage adjustment to protect your kidneys
  • Over-the-counter pain medicationsincluding nonsteroidal anti-inflammatory drugs
  • Antibiotics or anti-fungalsmay require changing to a kidney-friendly version
  • Diabetes medicationsmay need a dosage adjustment to be more kidney-friendly
  • Antacidswhich could cause imbalances in your body with CKD

Discuss any vitamins youre taking with your doctor. Vitamins you may need to avoid include:

  • Fat-soluble vitamins A, D, E, and Kwhich are more likely to build up in your system. These vitamins should not be taken unless your doctor prescribes them. Vitamin A can be toxic if too much is taken.


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