Medication is a critical component of chronic kidney disease (CKD) treatment. It can support your remaining kidney function, control related medical conditions, and slow the advance of kidney disease to kidney failure. The Institute for Quality and Efficiency in Health Care outlines which medications can help avoid complications and protect your major organs and vessels when you’re living with CKD.* 

What medications can help protect me and slow CKD progression?

Diabetes and hypertension are the leading causes of CKD, and heart disease is the leading cause of death for people with CKD. Once your diabetes is under control, keeping your heart healthy is the best way to slow CKD progression.

Some of the most common drugs used to do this include those that:

• Lower blood pressure
• Lower cholesterol
• Prevent blood clotting

Blood pressure medications

Your doctor is likely to prescribe blood pressure medication if you have:

• High blood pressure
• Diabetes, or
• High levels of albumin in your urine.

The medications most often prescribed for lowering blood pressure are angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), also called sartans.

• Angiotensin II is a chemical produced by your body that narrows your blood vessels, which causes your heart to work harder to pump blood.
• ACE inhibitors prevent your body from producing angiotensin II, and ARBs serve to block the angiotensin II receptors that are present in your heart, blood vessels, and kidneys.

A review of 119 studies involving participants with advanced kidney disease revealed that both ACE inhibitors and ARBs:

• Reduced the risk of kidney failure more effectively than other blood pressure drugs such as beta blockers
• Reduced the risk of cardiovascular diseases such as strokes and heart attacks

There is no evidence, however, that taking an ACE inhibitor and an ARB in combination is beneficial. Taking them together may be harmful, so you should not take them together unless prescribed as such by your healthcare provider.

Cholesterol medications

In addition to a healthy diet, regular exercise, and quitting smoking, most doctors help you lower your cholesterol by prescribing a type of medication called statins. Statins work by drawing out low-density lipoprotein (LDL) cholesterol, i.e., the “bad” cholesterol, and stabilizing the plaque in your bloodstream.

Plaque is a waxy substance that can build up in your arteries and interfere with blood flow to and from your heart. By lowering cholesterol levels, statins also reduce the risk of heart disease and stroke. Statins are usually given to CKD patients who do not yet need dialysis. It’s not known whether statins are effective if you start taking them after dialysis has been initiated.

Anti-clotting medications 

Anti-clotting medications are also known as anticoagulants and blood thinners. Acetylsalicylic acid (ASA), the active ingredient in medicines like aspirin, is the blood thinner most doctors prescribe. 

While anti-clotting drugs can help prevent heart attacks and strokes, they can also be dangerous if you are prone to bleeding. Don’t take blood thinners without consulting your healthcare provider. 

*Institute for Quality and Efficiency in Health Care. (2020, Mar. 8). Chronic kidney disease: Which medications can protect the kidney, heart and blood vessels?. https://www.ncbi.nlm.nih.gov/books/NBK492989/