1. Blood Pressure Control (Renal Protection)
These are first-line in CKD, especially with proteinuria.
ACE Inhibitors (ACEIs) Enalapril ,Lisinopril
ARBs Losartan, Valsartan
Benefits:↓ Slow CKD progression
Key Monitoring:⚠Creatinine (acceptable rise ≤30%)
âš Potassium (hyperkalemia risk)
đź’Š 2. Diabetes Management (Renal Protection)
Critical for diabetic nephropathy.
SGLT2 Inhibitors (Game-changer)Empagliflozin Dapagliflozin
Benefits:↓ CKD progression↓ CV mortality Works even in non-diabetic CKD
GLP-1 Receptor Agonists
Semaglutide Benefits:Glycemic control Cardiovascular protection
đź’Š 3. Diuretics (Fluid Control)Used for edema, hypertension, fluid overload Loop Diuretics. Furosemide Thiazides (early CKD)Hydrochlorothiazide
Note:Loop diuretics preferred in advanced CKD
💊 4. Anemia Management (CKD-related)CKD → ↓ erythropoietin → anemia ESAs (Erythropoiesis Stimulating Agents)
Epoetin alfaIron Supplements
Oral or IV ironTargets:Hb ~10–11 g/dL (avoid overcorrection)
đź’Š 5. Bone & Mineral Disorder (CKD-MBD) Phosphate Binders, Calcium carbonate Sevelamer ,Vitamin D Analogues ,Calcitriol
Goal:Control phosphate, calcium, PTH
đź’Š 6. Potassium Management For Hyperkalemia
Sodium polystyrene sulfonate, Patiromer
💊 7. Metabolic Acidosis Sodium bicarbonate Use:Maintain serum bicarbonate ≥22 mmol/L
đź’Š 8. Lipid Management (CV Risk Reduction)Atorvastatin
Reason:CKD = high cardiovascular risk
⚠️ Important Pharmacy Notes (Clinical Practice)
🚫 Avoid / Use with Caution NSAIDs → worsen kidney function
Metformin → caution in low eGFR Potassium-sparing drugs → hyperkalemia