Which medications are commonly used to treat hypertension in patients with kidney disease?

The use of ACE inhibitors, ARBs (angiotensin receptor blockers), and diuretics in treating hypertension in patients with kidney disease is well-established and supported by guidelines.

ACE inhibitors help lower blood pressure by preventing the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This action not only decreases blood pressure but also provides renal protection, especially in patients with conditions like diabetes mellitus. By reducing intraglomerular pressure, ACE inhibitors can help slow the progression of kidney disease.

ARBs offer a similar benefit as they block the action of angiotensin II. They may be preferred in patients who experience side effects from ACE inhibitors, such as cough, as ARBs do not typically cause this side effect. Both ACE inhibitors and ARBs have been shown to reduce cardiovascular risk, further supporting their use in patients with hypertension and kidney disease.

Diuretics are also commonly used, particularly in cases where fluid overload is a concern. They help to remove excess fluid from the body, lowering blood pressure and alleviating symptoms related to fluid retention.

In contrast, beta-blockers and calcium channel blockers, while used in hypertension management, do not have the same protective effects on the kidneys as ACE inhibitors and