ANTIHYPERTENSIVE MEDICATIONS FOR CHRONIC KIDNEY DISEASE IN PRIMARY CARE PRACTICE

Context: When managing patients with chronic kidney disease, proper management of hypertension that achieve sufficient control of blood pressure is considered to be one of the most important primary care interventions to decrease the severity of kidney disease and reduce the risk of patients developing cardiovascular events. The best mechanism when treating a patient with hypertension and chronic kidney disease is the blockage of the reninangiotensin-aldosterone system, such as angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARBs). Aim of work: We will discuss the importance of managing blood pressure in patients with chronic kidney disease, and emphasize the common medications used for this purpose. Methodology: We conducted a systematic comprehensive search in literature review using Medline, Pubmed, and Embase from January 1997 till March 2018. We used the terms: chronic kidney diseases, morbidity of kidney failure, ACE inhibitors, ARBs, diuretics Conclusions: Hypertension is prevalent among patients with chronic kidney disease, and the proper control of blood pressure has been shown to be signtficandy beneficial in these patients. A goal of keeping blood pressure less than 130490 mmHg should be targeted in chronic kidney disease patients, especially those who are diabetics. ACEls and ARBs are considered to be the best lines in the management of hypertension in chronic kidney disease patients. Other drugs include spironolactone and eplerenone, thiazides, MO and betablockers.