ERC drug dictionary: what they are and what they are used for

When diagnosed with chronic kidney disease, there is a list of drugs that we will have to start consuming and knowing. Izcay Ronderos, nephrologist internist at Baxter RCS, helped us create this practical guide.

To start talking about medicines for patients with CKD, we must start considering that the case of each patient is different and only the doctor can determine which medicine will be indicated for them. For these reasons it is important to insist that no patient should self-medicate.

The first thing the doctor will do is to diagnose CKD and determine the presence of pathologies that may be cause or associated with CKD such as high blood pressure, diabetes mellitus, and/or kidney diseases, also check if the patient has comorbidities associated with kidney disease such as changes in cholesterol, anemia or alterations in calcium and phosphorus metabolism. After diagnosis, the nephrologist will start the medicines required by the patient for the management of the pathology.

At the end of the consultation the patient will receive the explanation from the doctor to have very clear schedules and doses of each drug, as well as how to take it; given the above, it is recommended to have the medical formula noted in a visible place for the patient and/or caregiver of the patient and in case of any doubt, you should consult with the specialist before making any decision on your own.

With that being said, let’s start with some of the most common medicines and their functions

• Blood pressure control: losartan, enalapril, irbesartan, amlodipine, valsartan, nifedipine, metoprolol and clonidine, among others.
• Control of diabetes: metformin, dapagliflozin, Empagliflozin, linagliptin, sitagliptin, vildagliptin, basal insulin and rapid-acting insulin (with meals), liraglutide, semaglutide, etc
• Diuretics: improve the presence of inflammation (edema) and increase urinary volume. (furosemide, hydrochlorothiazide)
• Cholesterol and triglyceride control drugs such as Lovastatin, atorvastatin, rosuvastatin, ezetimibe, gemfibrozil. etc
• They are used for management of comorbidities in advanced chronic renal disease such as secondary hyperparathyroidism calcium supplements, calcitriol and phosphorus chelates and for the presence of anemia oral or intravenous iron and, in some cases, erythropoietin.
• Medicines for kidney diseases or some immunological diseases that affect the kidney such as systemic lupus erythematosus: prednisone, cyclophosphamide, deflazacort, mycophenolate, cyclosporine, azathioprine, etc.

Contraindicated drugs

In the case of chronic kidney disease, it is very important that patients have into account that in no case should they self-medicate. The drugs you consume should be carefully approved by a specialist doctor as a contraindicated one can put your life at risk.

As Ronderos explains, "it is contraindicated the use of antibiotics called aminoglycosides, such as gentamicin and amikacin; non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, dipyrone,  etoricoxib  and meloxicam; and do not forget the nutritional supplements that have high protein content such as ensure, glucerna, ensoy, etc, which should not be consumed when a patient has a diagnosis of chronic kidney disease.

Also, on internet many home remedies are suggested to treat CKD. However, this specialist insists that they are not the most advisable. “They may help improve functioning or control some pathology such as diabetes, but they can eventually alter kidney function. This is the case of infusions of Chinese herbs, which are used to "detoxify" the body, but which produce alteration of creatinine and severe nephropathy. Whenever a patient wants to take a "home remedy" or "naturist", it is important to discuss it with their nephrologist before making the decision," he explains.