One of the main ways to reduce the progression of kidney damage is to manage high blood pressure. Good control of blood pressure is vital to protect the kidneys.
People with CKD should aim to get their blood pressure down to below 140/90mmHg but if you also have diabetes you should aim to get it down to below 130/80mmHg.
There are many types of blood pressure drugs. Medicines called angiotensin converting enzyme (ACE) inhibitors are used to control high blood pressure in people with CKD.
As well as reducing blood pressure around the body and reducing the strain on blood vessels, ACE inhibitors give additional protection to the kidney.
ACE inhibitors include:
ramipril
enalapril
lisinopril
perindopril
Side effects of ACE inhibitors include:
a persistent, dry cough
dizziness
tiredness or weakness
headaches
Most of these side effects should pass within a few days, although some people continue to have a dry cough.
If the side effects of ACE inhibitors are particularly troublesome, you can be given an alternative medication called an angiotensin-II receptor blocker (ARB). This group of medicines includes:
candesartan
eprosartan
irbesartan
azilsartan
olmesartan
temisartan
valsartan
losartan
The side effects of ARBs are uncommon, but can include dizziness.
Both ACE inhibitors and ARBs can cause a reduction in kidney function in some people and increased levels of potassium in the blood, so blood tests will need to be performed after you start treatment and whenever the dose changes. If you are on an ACE inhibitor or ARB and you develop a fever/infection or need medicines for other conditions, it's important to ask your doctor if the ACE inhibitor or ARB needs to be temporarily stopped.
