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Which Blood Pressure Medicine Is Best For Kidney Disease

What Is High Blood Pressure

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Your heart pumps blood through tubes called your arteries and veins. This causes pressure inside of these tubes, which is called blood pressure. Checking your blood pressure tells you how hard your heart is working to pump your blood.

Blood pressure that is too high means your heart is working too hard to pump your blood. This can harm your body, including your kidneys.

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Polycystic Kidney Disease And High Blood Pressure: Tips For Managing

Polycystic kidney disease, or PKD, is an inherited disorder that causes fluid-filled cysts to grow in your kidneys. As the cysts grow in number and size, they affect your kidneys ability to function. Most people with PKD have a type called autosomal dominant polycystic kidney disease, or ADPKD. One of the most common complications of ADPKD is high blood pressure. Since untreated high blood pressure can cause further damage to your kidneys, its essential to try to get it under control. Here are some tips.

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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.

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How Does High Blood Pressure Affect The Kidneys

High blood pressure can constrict and narrow the blood vessels, which eventually damages and weakens them throughout the body, including in the kidneys. The narrowing reduces blood flow.

If your kidneys blood vessels are damaged, they may no longer work properly. When this happens, the kidneys are not able to remove all wastes and extra fluid from your body. Extra fluid in the blood vessels can raise your blood pressure even more, creating a dangerous cycle, and cause more damage leading to kidney failure.

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Pain Medication For People With Kidney Disease

The following information is also available as a downloadable leaflet:Pain medication for people with kidney disease

If you’d like to order a hard copy please see ourleaflets and booklets page

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Pain is one of the most common and distressing symptoms for people with chronic kidney disease . Take care when choosing a pain killer as some types should not be taken by people with kidney problems or should only be used with specialist guidance. When a pain killer is prescribed for you for either acute or chronic pain, a stepwise approach is used . This means that the weakest pain killer from the first step of the analgesic ladder is tried first. If you are still in pain, a stronger pain killer will be tried. Your pain and any side effects will be monitored closely.

This information explains the different types of pain killers recommended if you have kidney disease. This information is for older children and adults only.

What are the different types of painkillers?

The main types of pain killer are:

  • Paracetamol
  • Nonsteroidal anti-inflammatory drugs e.g. ibuprofen, naproxen
  • Weak opioids e.g. codeine, dihydrocodeine, tramadol
  • Strong opioids e.g. morphine, oxycodone, alfentanil
  • Others e.g. amitriptyline, gabapentin

The type of pain killer prescribed depends on how severe your pain is and where it is coming from.

What are the different types of pain killers?


More Information On Medicines

Are there medications for kidney disease?

We have a number of leaflets about the various medicines you may be prescribed depending on your condition:-

Note: these tablets can usually be stopped 6 months after a transplant.

Antibiotics used to treat haemodialysis line infections

  • Gentamicin

Note: usually given as a single dose injection, then blood levels need to be measured.

Antibiotics to treat peritonitis in peritoneal dialysis patients

  • Gentamicin
  • Vancomycin
  • Ciprofloxacin

Note: usually given as a course, either intravenously or in the dialysis fluid then blood levels need to be measured.

Drugs that lower blood pressure

  • Calcium antagonists
  • Beta-blockers
  • ACE-inhibitors or ‘Prils’
  • ARBs or ‘Sartams’

Note: all blood pressure tablets, if given in too high dosage, can cause low blood pressure and dizziness. ACE-inhibitors and ARBs can increase the potassium levels in the blood and cause or worsen kidney failure.

Water tablets

  • Furosemide
  • Metolazone

Note if given in too high dosage, these tablets can cause dehydration, low blood pressure and dizziness.

Spinolactone can cause the potassium levels in the blood to rise.

Drugs that control renal bone disease

Phosphate binders

Note: these tablets can also cause the calcium level in the blood to rise.


  • This drug has the advantage of not raising calcium levels.

Drugs that increase your blood count

  • Ferrous sulphate tablets
  • Iron injection
  • ESA injections

Drugs that control vasculitis

  • Stronger: azathioprine
  • Very strong: cyclophophamide

Drugs that thin your blood

  • Aspirin

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What Are Clinical Trials And Are They Right For You

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

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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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

Factors That Can Add Up To Cause Harm

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

When you get sick from something like the flu or diarrhea, or have trouble drinking enough fluids, the blood pressure in your body may decrease. As a result, the pressure in your kidneys can be low, too.

In most cases, healthy kidneys can protect themselves. However, if you keep taking your blood pressure medicines when youre dehydrated or have low blood pressure, your kidneys might have a hard time protecting themselves. The pressure within your kidneys might drop so low that your kidneys wont filter normally.

If youre dehydrated, NSAIDs can also keep your kidneys from protecting themselves. As a result, taking NSAIDs when youre sick and dehydrated can cause kidney injury.

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How Is Hypertension Treated

Although there are several drugs that are very effective in treating human hypertension, none of these are approved for use in cats. Research efforts have determined that some of these drugs are quite effective in cats. Studies are still being done to determine which drugs are the safest and most reliable.

Some of the most commonly used medications for maintenance are amlodipine and the ACE inhibitor class of drugs benazepril and enalapril. Less commonly used drugs include beta blocker type drugs such as atenolol and propranolol or a diuretic called spironolactone. Additionally, if the hypertension is due to an underlying disease, it must also be addressed directly. Your veterinarian will recommend the best treatment options for your cat based on her specific needs.

What Are The Clinical Signs Of High Blood Pressure In Cats

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.

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Study Cohort Outcomes And Follow

In this nationwide longitudinal population-based cohort study, individuals aged40 years with CKD at baseline who underwentone national health examination between January 2009 and December 2010 were included. CKD was defined as the eGFR< 60 ml/min/1.73 m2. The time-point of the examination conducted between 2009 and 2010 was considered as the baseline. The individuals with a history of myocardial infarction , stroke , heart failure , and/or ESRD at or before baseline, and those with malignancies throughout the study period were excluded. The individuals who cannot be classified as users or non-users of antihypertensive medications and those with missing data for at least one variable were also excluded .

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Kidney Disease Treatment: Prevent CKD progression with blood pressure control

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How Can I Prevent Or Slow The Progression Of Kidney Disease From High Blood Pressure

The best way to slow or prevent kidney disease from high blood pressure is to take steps to lower your blood pressure. These steps include a combination of medicines and lifestyle changes, such as

  • being physically active
  • managing stress
  • following a healthy diet, including less sodium intake

No matter what the cause of your kidney disease, high blood pressure can make your kidneys worse. If you have kidney disease, you should talk with your health care professional about your individual blood pressure goals and how often you should have your blood pressure checked.

How Will I Know Whether I Have Kidney Damage

Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. Blood tests will show whether your kidneys are removing wastes efficiently. Your doctor should order tests to measure your serum creatinine. Having too much creatinine in your blood is a sign that you have kidney damage. The doctor should use the serum creatinine to estimate the main kidney function called glomerular filtration rate, or GFR. Another sign is proteinuria, or protein in your urine. Proteinuria has also been shown to be associated with heart disease and damaged blood vessels. .)

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National Kidney And Urologic Diseases Information Clearinghouse

3 Information Way Phone: 18008915390 Fax: 7037384929 Internet: The National Kidney and Urologic Diseases Information Clearinghouse is a service of the National Institute of Diabetes and Digestive and Kidney Diseases . The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1987, the Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. The NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases. Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication was also reviewed by Vito M. Campese, M.D., University of Southern California, and Matthew Weir, M.D., University of Maryland. This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

NIH Publication No. 054572 August 2005


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