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Medications for Chronic Kidney Disease

Medicines may help stop further harm to the kidneys. They also treat other health problems that can happen with chronic kidney disease (CKD).

Your medicines may not work as they did before. CKD changes your body’s chemistry. Your doctor may stop or change them if this is the case. This can also happen with over-the-counter (OTC) medicines or supplements. Don’t change, stop, or take medicines unless you talk to your doctor first.

Medicines treat:

High Blood Pressure

High blood pressure is a common cause of CKD.

Medicines used to treat high blood pressure:

ACE Inhibitors

Can help the blood vessels relax. This lessens the pressure in the blood vessels.

Common names:

  • Benazepril
  • Captopril
  • Enalapril
  • Fosinopril
  • Lisinopril
  • Moexipril
  • Perindopril
  • Quinapril
  • Ramipril
  • Trandolapril

Possible side effects:

  • Dry cough
  • Headache
  • Lightheadedness
  • Feeling tired

Angiotensin-II Receptor Blockers (ARBs)

ARBs block certain actions that raise blood pressure.

Common names:

  • Candesartan
  • Eprosartan
  • Irbesartan
  • Olmesartan
  • Telmisartan
  • Valsartan
  • Losartan

Possible side effects:

  • Feeling tired
  • Lightheadedness

Diuretics

Loop diuretics make more urine. As a result, you may go to the bathroom more often. This helps rid the body of extra fluid.

Common names:

  • Bumetanide
  • Furosemide
  • Torsemide

Possible side effects:

  • Muscle cramps
  • Lightheadedness
  • Higher blood glucose levels

Diabetes

High blood glucose levels make CKD worse. It causes harm to the tiny filters in the kidney.

Medicines used to treat diabetes:

Glucose-lowering Pills

Glucose-lowering pills reduce blood glucose. Each of the 5 types works in a different way and has different side effects.

Sulfonylureas

Will prompt the body to make more insulin. Insulin moves glucose out of the blood and into cells.

Common names:

  • Chlorpropamide
  • Glipizide
  • Glyburide
  • Glimepiride

Possible side effects:

  • Low blood sugar—hypoglycemia
  • Headache
  • Weight gain
  • Interaction with alcohol
Meglitinides

Prompts the body to make more insulin. Insulin moves glucose out of the blood and into cells.

Common names:

  • Repaglinide
  • Nateglinide

Possible side effects:

Biguanides

This medicine can lower the amount of blood glucose made by the liver. It will also make it easier for muscles to use insulin.

Common name: metformin

Possible side effects: diarrhea

Thiazolidinediones

Work by lowering the amount of blood glucose made by the liver. They also help muscle and fat tissue use insulin.

Common names:

  • Rosiglitazone
  • Troglitazone
  • Pioglitazone

Possible side effects:

Alpha-glucosidase inhibitors

Stops the breakdown of starch in the intestines. This slows the rise in blood glucose after a meal.

Common names:

  • Acarbose
  • Miglitol

Possible side effects:

  • Gas
  • Diarrhea

Insulin Injections

Your body needs insulin to use blood glucose correctly. People who have diabetes may need to take it. It’s given as a shot.

Insulin types:

Rapid-acting insulin —Can lower blood glucose in about 5 minutes. They are effective for 2 to 4 hours.

Regular or short-acting insulin — Can start in about 30 minutes. It continues to work for about 3 to 6 hours.

Intermediate-acting insulin — Can reach the bloodstream about 2 to 4 hours after injection. It will work for about 12 to 18 hours.

Long-acting insulin —Reaches the bloodstream in about 6 to 10 hours. It is usually effective for 20 to 24 hours. May be called Ultralente.

Very long-acting insulin —Starts to lower blood glucose levels in about 1 hour. It works for 24 hours.

Insulin can lead to low blood sugar. If you are taking insulin, keep track of what you eat. Check your blood glucose levels as advised.

High Cholesterol     TOP

CKD auses high cholesterol in the blood. This raises the risk of a heart attack or stroke. Triglycerides are often raised in people with CKD.

Medicines used to treat high cholesterol:

Fibrates

Can help to lower triglyceride levels.

Common names:

  • Fenofibrate
  • Gemfibrozil

Possible side effects:

  • Muscle damage
  • Gallstones
  • Liver damage

Statins

Statins block a process in a long chain of events in the body needed to make cholesterol.

Common names:

  • Atorvastatin
  • Fluvastatin
  • Lovastatin
  • Pravastatin
  • Rosuvastatin
  • Simvastatin

Possible side effects:

  • Headache
  • Muscle aches
  • Muscle damage
  • Liver damage

Cholesterol Absorption Inhibitors

Lowers the amount of cholesterol and fats that are absorbed in the intestine.

Common name: ezetimibe

Possible side effects:

  • Back pain
  • Belly pain
  • Liver damage

Bone Problems    TOP

CKD raises the phosphorus and parathyroid hormone in your blood. This can make your bones weak. Lowering the amount of phosphorus in your diet can help.

Medicines used to treat bone problems:

Phosphorus Binders

Can lower the amount of phosphorus that you get from food. It is taken with meals.

  • Calcium-containing medicines—calcium carbonate, calcium acetate, and calcium citrate
  • Magnesium carbonate
  • Aluminum hydroxide
  • Aluminum carbonate
  • Sevelamer hydrochloride

Possible side effects: belly pain

Vitamin D

Lowers the level of parathyroid hormone in your body. High hormone levels cause the bones to become weak.

Common names:

  • Calcitriol
  • Alfacalcidol
  • Doxercalciferol

Possible side effects:

Anemia    TOP

The kidneys make a hormone called erythropoietin. It helps your body make red blood cells. In CKD, the level of this hormone can decrease. The number of red blood cells then decrease and can lead to anemia.

Erythropoietin

This medicine is injected. It prompts the body to make more red blood cells.

Possible side effects:

Iron Supplements

Some people with CKD have low levels of iron in the blood. If you do, your doctor may advise iron supplements.

Possible side effects:

  • Nausea
  • Vomiting
  • Belly pain

High Potassium    TOP

CKD can lead to high potassium levels. Care may involve:

  • Sodium polystyrene sulfonate
  • Insulin in dextrose through an IV—for very high levels

References:

About chronic kidney disease. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/about-chronic-kidney-disease. Updated February 15, 2017. Accessed June 19, 2018.
Chronic kidney disease. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/chronic-kidney-disease/chronic-kidney-disease. Updated March 2017. Accessed June 19, 2018.
Chronic kidney disease (CKD). Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/chronic-kidney-disease-ckd. Updated August 9, 2017. Accessed June 19, 2018.
Chronic kidney disease (CKD) in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 14, 2018. Accessed June 19, 2018.
Insulin & other injectables. American Diabetes Association website. Available at:
...(Click grey area to select URL)
Accessed June 19, 2018.
Managing chronic kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/managing. Updated October 2016. Accessed June 19, 2018.
Medication. American Diabetes Association website.
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Accessed June 19, 2019.
Last reviewed June 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/19/2018

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