OPTIMIZING ANTIHYPERTENSIVE THERAPY IN CHRONIC KIDNEY DISEASE (CKD) PATIENTS: A REVIEW OF DOSE ADJUSTMENTS AND CLINICAL CONSIDERATIONS

KANCHAN SHELKE; TEJAS PARKHE; DHANRAJ SHINDE

doi:10.22159/ijpps.2025v17i8.54827

Authors

KANCHAN SHELKE Doctor of Pharmacy, Modern College of Pharmacy, Nigdi, Pune, Mumbai, India https://orcid.org/0009-0008-0343-0109
TEJAS PARKHE Doctor of Pharmacy, Modern College of Pharmacy, Nigdi, Pune, Mumbai, India https://orcid.org/0009-0001-6291-8613
DHANRAJ SHINDE Intensive and Pediatric Care Clinical Pharmacist, Deenanath Mangeshkar Hospital and Research Center, Pune, India https://orcid.org/0009-0002-3421-8772

DOI:

https://doi.org/10.22159/ijpps.2025v17i8.54827

Keywords:

Chronic kidney disease (CKD), Hypertension, Blood pressure (BP), Renin-angiotensin-aldosterone system (RAAS), ACE inhibitors (ACEI), Angiotensin receptor blockers (ARB), Calcium channel blockers (CCB), Combination therapy in CKD, Guideline-based treatment, Sympathetic nervous system (SNS)

Abstract

Hypertension both causes and is caused by chronic kidney disease (CKD), requiring cautious management strategies to prevent renal and cardiovascular issues. To assure safety and reach a blood pressure (BP) goal of less than 130/80 mmHg, the current study aims to evaluate antihypertensive therapy in participants with chronic kidney disease (CKD), with particular attention to drug selection, combination regimens, dose adjustment, and individual characteristics. Identification of ideal first-line therapy, determination of the best mix of effective combinations, and solutions to issues such as drug-resistant hypertension and harmful drug interactions are among the priority objectives.

Due to their renoprotective and antiproteinuric effects, ACEIs and ARBs are necessary in CKD. CCBs, diuretics, or aldosterone antagonists as part of combination therapy reduce blood pressure. Proteinuria is reduced, and newer drugs, along with sodium limitation, improve treatment efficacy. The present review provides dose modification and appropriate antihypertensive drug options for individuals with chronic kidney disease.

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