CKD Flashcards
Non Duhydropyridine CCB
- Verapamil and DIltiazem*
proteinuric effect
slow progression on CKD - do not combine with beta-blockers
Dihydropyridine CCB
- Amlodipine and Nifedipine*
- no effect on proteinuria
- risk of edema
Lotensin
Benazepril
start dose: 5 mg qd
max dose: 80 mg
60 & renal 40% biliary
Capoten
Captopril
50% renal and 50% hepatic
Vasotec
Enalapril
95% renal
Monopril
Fosinopril
50% renal and 50% hepatic
Zestril/Prinivil
Lisinopril
100% renal
Moexipril
Univasc
7% urine and 63% feces
Accupril
Quinapril
96% renal
Altace
Ramipril
60% renal and 405% feces
Mavik
Trandolopril
33% urine and 66% feces
Edarbi
azilsartan
55% feces and 42% urine
Atacand
Candestartan
65% hepatic and 35% renal
Teveten
Eprosartan
90% feces and 7% urine
Avapro
Irbesartan
80% hepatic and 20% renal
Coozar
Losartan
60% feces and 40% urine
Benicar
Olmasartan
50% feces and 50% urine
Micardis
Telmisartan
97% feces
Diovan
Valsartan
84% feces
13% urine
Aliskiren
Brand: Tekturna
- direct renin inhibitor
- contraindications: pregnancy, combination with ACE/ARBS
RAAS absolute contraindications
- pregnancy
- Bilateral renal artery stenosis
- history of ACE/ARBS related angioedema
RAAS dose adjustment based on GFR
GFR 0-15% no change
15-30% no change
30-50: cut dose in half and check in a week
>50% hold therapy
RAAS side effects
hypotension orthostasis dizziness cough (more w arbs) hyperkalemia angioedema
RAAS and NSAID
AKI
RAAS and K+
hyperkalemia
RAAS x 2
AKI and Hyperkalemia
SGLT 2 inh
“-glifozins”
- aki
- euglycemic diabetic ketoacidosis
- UTI
- lower limb amputations
Allopurinol and Febuxostat
decrease uric acid ( goals is <7%)
prevention:
- 1.5 mg x eGFR
- Stevens Johnson Syndrome
Albuminuria
A1: <30
A2: 30-300
A3: >300
GFR category
G1 Normal to high >90 G2: Mildly decreased 60-89 G3a Mild to moderately decreases 45-59 G3b: Moderately to severely decreased 44-30 G4: severely decreased 15-29 G5: Kidney failure <15
