Why Do Kidney Patients Take Hypotensive Drugs
In a physical examination, Mr Wang was diagnosed with urine protein 2+, occult blood 2+, normal blood pressure and serum creatinine. He did renal biopsy and the pathological diagnosis is IgA Nephropathy. The doctor gave him some medicines for protecting kidneys and also prescribed him hypotensive drugs. He felt puzzled that his blood pressure was normal. Why did the doctor give him hypotensive drugs?
IgA Nephropathy is the common chronic nephritis and the clinical manifestations are proteinuria and bloody urine. In severe case, elevated blood pressure and abnormal kidney function will occur. The core treatment for kidney disease is to relieve proteinuria and hematuria, and delay the progression of kidney function deterioration. It is very insidious in some patients in the early stage of kidney disease and it is often detected in a physical examination. At that time, blood pressure is normal but kidney is in a state of high workload from some examination results. So-called antihypertensive agents, such as: angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor inhibitor (ARB), etc, have the function of reducing high pressure of kidney. They can significantly reduce the patient's proteinuria by dilating the glomerular effusive arterioles, and delay glomerular sclerosis and renal tubulointerstitial fibrosis, thus benefiting the patient and delaying the progression of renal disease. Therefore, for some patients with proteinuria, as long as the blood pressure can be tolerated and the serum creatinine is lower than 3 mg/dl, ACEI antihypertensive drugs are recommended to be added routinely. Some patients are sensitive to ACEI, and those with stimulating dry cough should take angiotensin II receptor antagonist (ARB).
At present, more and more doctors regard ACEI or ARB as the leading drug for protein elimination and kidney protection, and their role goes far beyond the scope of antihypertensive therapy. Even so, when patients have dizziness, severe weakness and other postural hypotension symptoms after taking medicines, or sudden deterioration of kidney function, elevated potassium and refractory cough, they should stop taking ACEI or ARB immediately.
It makes more sense for the patients with chronic nephritis but normal blood pressure to take antihypertensive drugs such as RAAS inhibitors. They can protect kidneys. Besides, follow-up visit is necessary. If any discomforts occur, see your doctor at once and adjust your medicines.
***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***