Kidney patients must know this guide to using antihypertensive drugs

This is the 3552nd article of Da Yi Xiao Hu

Blood pressure control is a "compulsory course" for every kidney disease patient. Long-term high blood pressure will cause long-term damage to the kidneys and seriously affect the prognosis of kidney disease. Therefore, it is necessary to pay attention to the impact of high blood pressure on kidney function. Next, let's talk about how kidney disease patients can control their blood pressure.

1. A healthy lifestyle is the cornerstone for kidney disease patients to control blood pressure

Adjusting your lifestyle and improving your diet are the cornerstones of controlling blood pressure. When combined with medication, they can achieve twice the result with half the effort. Specifically, avoid eating pickled and high-fat foods, and control your potassium and sodium intake; maintain a good attitude and avoid mood swings; maintain a regular work and rest schedule, quit smoking and drinking, exercise appropriately to control your weight, and improve your physical fitness.

In addition, monitoring blood pressure is a habit that patients must pay attention to. Blood pressure will fluctuate over time, and taking medicine requires "time". It is recommended that patients do 24-hour dynamic blood pressure monitoring twice a year in spring, summer, autumn and winter to understand their blood pressure changes and tailor their medication to achieve the ideal blood pressure lowering effect.

2. Rational use of antihypertensive drugs is the key to achieving blood pressure targets in patients with kidney disease

The development of kidney disease and the appearance of hypertension are often chronic processes. Most people who develop renal insufficiency generally need to take medication for a long time. Whether the use of antihypertensive drugs is reasonable and standardized not only affects the blood pressure level, but also affects the stability of renal function. Patients must strictly follow the time and dosage of medication.

The use of antihypertensive drugs is very particular.

For example, when taking antihypertensive drugs such as pril or sartan, you need to pay attention to monitoring changes in blood creatinine and blood potassium levels, because both types of drugs have the risk of causing acute kidney injury and are more likely to cause hyperkalemia.

Diuretics are generally not suitable for continuous use for a long period of time, and renal function, electrolytes and blood sugar need to be monitored, because long-term use can cause increased uric acid and blood sugar. Diuretics are also one of the risk drugs for causing acute kidney injury.

Antihypertensive drugs such as Betaloc and Clonidine are also very common. For these two types of drugs, the heart rate and pulse need to be monitored during the use. If the heart rate and pulse are lower than 60 beats/minute, you need to be very careful because they both inhibit cardiac conduction and slow down the heart rate. If the heartbeat suddenly slows down or causes cardiac arrest, it is very dangerous. Therefore, it is recommended that patients who take these two types of drugs may wish to self-test their pulse and heart rate more often, and adjust the dosage in time under the guidance of professional doctors.

3. Traditional Chinese medicine has advantages in improving hypertension-related symptoms in patients with kidney disease

Some patient friends often say to me, "Doctor Gong, after I followed your advice and drank more celery water and winter melon peel soup, not only did the edema decrease a lot, but my blood pressure also stabilized. Do these foods have a blood pressure lowering effect?" These patients are right. Some ingredients and Chinese herbal medicines (such as Uncaria rhynchophylla, Cassia tora, Gastrodia elata, etc.) do have the effect of lowering blood pressure, and have the characteristics of small side effects and are very safe, which is worthy of reference and use.

In general, a healthy lifestyle and individualized treatment combining traditional Chinese and Western medicine are two magic weapons for kidney patients to control blood pressure. Actively controlling blood pressure is conducive to improving the prognosis of kidney disease. I believe that through active and effective cooperation between doctors and patients, the blood pressure control problem of kidney patients will be better solved.

Author: Department of Nephrology, Shanghai Hospital of Traditional Chinese Medicine

Chief Physician, Professor, Doctoral Supervisor

Gong Xuezhong

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