In chronic kidney disease, drug treatment can prevent the disease from progressing. Antihypertensive drugs are particularly important.
Drugs can help to stop or slow down the progression of chronic kidney disease and protect against consequences such as heart attacks. Which remedies are suitable for a person with chronic kidney disease depends, for example, on existing concomitant diseases and the individual risk of complications.
Whether it makes sense to lower blood pressure in people with chronic kidney disease depends on this,
-how high the blood pressure is (without treatment),
-if diabetes mellitus exists,
-how much protein the urine contains (albumin value).
For example, if you have normal blood pressure, are not suffering from diabetes mellitus and hardly any albumin is excreted in the urine, you can do without antihypertensive medication. For high blood pressure, diabetes or high levels of albumin in the urine, however, therapy with so-called ACE inhibitors (angiotensin-converting enzyme inhibitors) or Sartans (angiotensin antagonists) is recommended. Blood sugar lowering therapy is also important for people with diabetes.
An evaluation of 119 studies involving a total of more than 64,000 participants with advanced kidney disease has shown that ACE inhibitors and Sartain have several advantages: Compared with other blood pressure medications (such as beta-blockers), ACE inhibitors or Sartane have reduced the risk of complete kidney failure. The therapy also reduced the risk of cardiovascular diseases such as heart attacks and strokes.
Whether it helps to take an ACE inhibitor together with a Sartan in chronic kidney disease has not been proven. The combination may be more harmful.
Cholesterol-lowering drugs (statins)
Statins are drugs that lower the cholesterol level in the blood. For example, they are prescribed after a heart attack because they can protect against further cardiovascular problems and prolong life. Studies suggest that this also applies to people with chronic kidney disease who do not yet need dialysis. They are therefore usually recommended to start statin therapy. As a rule, the therapy is continued if dialysis becomes necessary.
It is still unclear whether statins also slow down the progression of kidney disease. It is also unclear whether it is useful to start taking the drugs when dialysis has already started.
Drugs that reduce the blood’s ability to clot are called anticoagulants or blood thinners. These include acetylsalicylic acid. Anticoagulants can prevent a heart attack or stroke, but they can also cause bleeding.
The benefits and harms of anticoagulants must therefore always be carefully weighed against each other. Taking anticoagulants, for example, can do more harm than good for some people with mild kidney weakness. However, the drugs can be useful if there is an increased risk of heart attack, for example, if coronary heart disease is also present.
Uric acid-lowering therapy
Due to weakened kidney function, uric acid salts (urate) can accumulate in the blood. This can lead to gout attacks. Drugs such as allopurinol lower uric acid levels and can help prevent gout attacks, but can also cause side effects such as skin rash or nausea. Initial studies have shown that allopurinol can slow the progression of chronic kidney disease and prevent cardiovascular complications. However, further studies are needed to prove this benefit.
What are the benefits of dietary supplements?
It is more than doubtful whether over-the-counter dietary supplements can help with chronic kidney disease. It has been proven, for example, that antioxidants such as vitamin E preparations neither prolong the lives of people with chronic kidney disease nor prevent complications such as heart attacks or strokes. To date, there is also no evidence that the drugs slow the progression of the disease or benefit certain people (such as dialysis patients). This also applies to fish oil and omega-3 fatty acid preparations.