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The Question
06/12/09 01:53 PM

"What combination of blood pressure meds are good for diabetics and kidney disease on Peritoneal dialysis"
Asked By: virtsma  
Category: Kidney Disease

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I want to ask my doctor to change my meds my blood pressure is high..

Expert Answers (1)

10/06/09 04:01 PM

Hello VirtSMa: With your history, I would guess you are also working with a renal dietitian, and with the frequent CAPD, monitoring the constant changes: blood glucose, electrolytes, proteins, nitrogen values, and other medications are a huge challenge. I'm sure your nephrologists is aware, however the best medications for keeping blood pressure in check, especially with diabetes, is the one or combination that keeps the pressures less than 130/80mmHg. Our individual physiology; what works for one person may not work for another.

In general, for every 10mmHg reduction in systolic blood pressure, the risk for any complication for Diabetes is reduced by 12%. Both systolic and diastolic hypertension markedly accelerates the Progression of diabetic nephropathy, and aggressive management is able to greatly decrease the rate of kidney functions' decline. Medication treatment are usually within the classification of angiotensin converting enzyme inhibitor or ACE inhibitors (ACE-I) or angiotensin receptor blockers (ARBs) both effective in reducing the decline in kidney functions much more effective than other blood pressure-lowering drugs.

These medications reduce proteinuria and preserve kidney function, delaying or decreasing the incidence of kidney failure and the progression of the disease. The ACE inhibitors and ARBs are essential to the treatment of persons with diabetes, they can have side-effects including elevated serum potassium levels (hyperkalemia) and altered kidney functions. Dietary sodium restriction is required because a high-salt diet can override the antiproteinuric effects of ACE-I and ARBs. Salt restriction is particularly important in hypertensive persons with proteinuria. Considering these additional factors, coordination with medical management and nutritional management are very important. Hope this helps and thanks for asking dLife. Regards Sue

Answered By: Susan Throop
Accreditations: RD, CDE, MA
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