Selection of antihypertensive drugs in dialysis patients
Diuretics can be blood pressure, but patients with high creatinine is usually ineffective, in addition it has ototoxicity, urinary dialysis patients are not recommended to use a diuretic to buck.
In addition to diuretics, all antihypertensive drugs can be used for dialysis patients with antihypertensive therapy.
1. Angiotensin-converting enzyme inhibitor (ACEI), that is, with the name "Plymouth" antihypertensive drugs, in addition to fosinopril, the other will be removed by dialysis, so need to be added after dialysis.
Conversely, an angiotensin receptor blocker (ARB), a hypotensive drug with the name "salbutamol", will not be removed by dialysis and will not need to be replenished after dialysis.
In general, support for dialysis patients in the application of ACEI or ARB class antihypertensive drugs, they also have partial protection of the heart.
2. mineralocorticoid receptor antagonist, can be used for dialysis patients with oliguria, can reduce cardiovascular damage, but also to reduce the occurrence of hyperkalemia.
3. Beta-blockers: (atenolol, metoprolol, metoprolol, labetalol, bisoprolol, Bo Su).
These antihypertensive drugs are easily removed during hemodialysis.
Another concern is that it has a high risk of hyperkalemia, there are reports that Nadolol, and Labetalol have this side effect, to be used with caution.
4. Calcium Antagonist (CCB): The name of the majority of antihypertensive drugs with "horizon", usually not dialysis removed, often with other antihypertensive drugs in combination, to reduce blood pressure for dialysis patients.
It and "Puli class" antihypertensive drugs, like the heart has a partial protective effect.
With the above antihypertensive drugs, blood pressure or drop down, how do?
Clonidine can be used for difficult to control high blood pressure.
If a variety of antihypertensive drugs do not work, you can use long-pressure set, hydralazine, but note that when taking such drugs, usually before going to bed medication.
