A number of prescription drugs can help manage CKD, including ones that treat diabetes and high blood pressure, two health conditions that are closely linked to this disease.
Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors
These drugs were developed to treat type 2 diabetes, but they are also effective at slowing down CKD progression.
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SGLT2 inhibitors work by helping your kidneys remove more sugar and salt from your body through the urine. Medications in this class include:
- canagliflozin (Invokana)
- dapagliflozin (Farxiga)
- empagliflozin (Jardiance)
Canagliflozin is an option specifically for people who have type 2 diabetes and CKD, but dapagliflozin and empagliflozin can both be used by people with CKD who don’t have diabetes.
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Some possible side effects include more frequent urination, low blood pressure, and a decrease in estimated glomerular filtration rate (eGFR), which is a measurement of how well your kidneys are filtering waste and excess fluid from your blood.
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Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists
Better known as the drug class that includes the weight loss phenomenon Ozempic (semaglutide), GLP-1s have also been approved by the U.S. Food and Drug Administration to treat people with type 2 diabetes and chronic kidney disease. These drugs protect the kidneys from damage by lowering blood sugar.
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Other medications in this class include:
- tirzepatide (Mounjaro, Zepbound)
- dulglutide (Trulicity)
- extendatide (Bydureon)
- liraglutide (Victoza)
Renin-Angiotensin System Inhibitors (RASi)
This is a broader classification of drugs that includes ACE inhibitors and angiotensin II receptor blockers (ARBs). Both medications can protect the kidneys, and they’re also prescribed for high blood pressure and heart failure.
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Joseph A. Vassalotti, MD, the chief medical officer of the National Kidney Foundation and a clinical professor with the Icahn School of Medicine at Mount Sinai, says these drugs are often one of the first medications prescribed for CKD.Medications in the ACE inhibitor class include:
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- lisinopril (Prinivil, Zestril)
- perindopril (Aceon)
- ramipril (Altace)
Medications in the ARB class include:
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- losartan (Cozaar)
- olmesartan (Benicar)
- valsartan (Diovan)
Common side effects of ARBs and ACE inhibitors include possible blood pressure drops, fatigue, and cough, which is more common with ACE than ARB medications.
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Statins
Statins are medications that lower cholesterol to improve blood flow and prevent cardiovascular disease. Some evidence suggests that these meds may help with inflammation and slow down CKD progression.
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Statins are considered a first-line therapy in people with CKD.
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Some examples of statins include:
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- atorvastatin (Lipitor)
- rosuvastatin (Crestor)
- simvastatin (Zocor)
Possible side effects of statins include digestive problems, mental fuzziness, and muscle pain.
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Diuretics
Diuretics help your body get rid of extra salt and fluid, which can help treat high blood pressure and also control the swelling that often accompanies kidney decline. Three different types of diuretics — thiazide, loop, and potassium-sparing — can be prescribed depending on how well your kidneys are working and which other health concerns you have.
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Some of the diuretic drugs that can be used in CKD are:
- bumetanide (Bumex)
- chlorthalidone
- furosemide (Lasix)
- hydrochlorothiazide
- metolazone
One loop diuretic, bumetanide, is approved in a nasal spray form (Enbumyst) that you can use at home to treat swelling associated with CKD. It’s meant to be a short-term solution for symptoms that get worse suddenly.
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