Medications for Chronic Kidney Disease

5 min read

Reviewed by: HU Medical Review Board | Last reviewed: January 2024 | Last updated: February 2024

Doctors prescribe many different medications to treat chronic kidney disease (CKD). These medicines help maintain balance and reduce the buildup of toxins in the body when the kidneys are not working well.^1,2

Treatments for CKD focus on managing symptoms, reducing problems caused by kidney damage, and prolonging kidney function. The medicines you take depend on several things:^1,2

Your existing kidney function (how well your kidneys are working)
The stage of your kidney disease
Other health conditions (comorbidities) or related health problems (complications) that affect your kidneys

Medicines for high blood sugar

Diabetes is the most common cause of kidney disease.¹

People with diabetes have uncontrolled blood sugar. High blood sugar puts extra strain on kidneys. People with diabetes must keep their blood sugar under control to preserve their kidney function. This can help slow the progression of kidney damage.¹

Slowing down kidney damage for people with diabetes is done with a few different types of medicines:

Sodium-glucose cotransporter-2 (SGLT2) inhibitors

Sodium-glucose cotransporter-2 (SGLT2) inhibitors help control blood sugar. They are often prescribed for people with type 2 diabetes (T2D). They are also helpful in treating people with CKD.^3,4

Examples of SGLT2 inhibitors your doctor might prescribe to control your blood sugar include:^3-5

Dapagliflozin (Farxiga^®)
Canagliflozin (Invokana^®)
Empagliflozin (Jardiance^®)
Ertugliflozin (Steglatro^®)
Sotagliflozin (Inpefa^®)

Non-steroidal mineralocorticoid receptor antagonists (MRAs)

Non-steroidal mineralocorticoid receptor antagonists (MRAs) slow down the progression of kidney damage. They do this by blocking mineralocorticoid receptor (MR) overactivation in the kidneys, heart, and blood vessels. MR overactivation may cause inflammation and scarring that can escalate kidney damage. MRAs are used for people who have CKD associated with T2D.⁶

Finerenone (Kerendia^®) is the only MRA drug approved to treat CKD in people with T2D. It reduces the level of protein (albumin) in urine in people with T2D and CKD. Finerenone is the first medicine approved in its class that slows the progression of CKD in people with T2D. It may delay the need for dialysis.^6,7

Medicines for high blood pressure

High blood pressure damages your kidneys. It is the second leading cause of kidney disease.^1,2

Lowering your blood pressure can help prolong your kidney function. Many types of blood pressure medicines may be prescribed for people with kidney disease.^1,2

Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors reduce blood pressure by widening blood vessels and reducing hormones that affect blood pressure. Some examples of ACE inhibitors are:^1,8

Benazepril (Lotensin^®)
Captopril (Capoten^®)
Enalapril (Vasotec^®)
Fosinopril (Monopril^®)

Angiotensin receptor blockers (ARBs)

ARBs lower blood pressure by widening blood vessels as well. Examples of ARBs include:^1,9

Losartan (Cozaar^®)
Valsartan (Diovan^®)
Candesartan (Atacand^®)
Irbesartan (Avapro^®)

Calcium channel blockers

Calcium channel blockers stop the entry of calcium into the cells of blood vessels. This causes the blood vessels to widen and reduces stress on the blood vessels, thus lowering blood pressure. Examples of calcium channel blockers include:¹⁰

Amlodipine (Norvasc®)
Diltiazem
Felodipine (Plendil^®)
Nifedipine (Procardia®)
Verapamil

Beta-blockers

Beta-blockers stop the production of adrenaline. Adrenaline is a hormone that causes your heart rate and blood pressure to rise. Beta-blockers slow your heart rate down and reduce the force at which the heart pumps. This lowers your blood pressure.^1,10

Examples of beta-blockers include:¹⁰

Acebutolol
Atenolol (Tenormin®)
Bisoprolol (Zebeta®)
Metoprolol (Lopressor®, Toprol XL®)
Carvedilol (Coreg®)

Diuretics

Diuretics are water pills that help you produce more pee (urine). When you pee more, you help your kidneys flush out extra salt and waste in your blood. Examples of diuretics include:^1,11

Chlorothiazide (Diuril®)
Furosemide (Lasix®)
Bumetanide (Bumex®)
Ethacrynic acid (Edecrin®)
Amiloride (Midamor)

Medicines for high cholesterol

High cholesterol can clog your arteries and make it harder for blood to flow throughout your body. This lack of blood flow damages your kidneys and can lead to kidney failure over time.^1,12

Statins are drugs that help lower cholesterol. They are commonly prescribed for people with high cholesterol. Some examples of statins are:^1,12

Atorvastatin (Lipitor®)
Fluvastatin (Lescol®)
Rosuvastatin (Crestor®)
Simvastatin (Zocor®)

Medicines for heart disease

The heart is another organ affected by kidney damage. CKD can lead to heart disease. Medicines used to treat heart disease include:¹

ACE inhibitors/ARBs
Beta-blockers
Diuretics
Potassium binders
SGLT2 inhibitors

Medicines for high potassium

When your kidneys are damaged, potassium builds up in your body. Too much potassium can hurt your heart. Potassium binders help get rid of extra potassium. Examples include:^1,14

Patiromer (Veltassa™)
Sodium polystyrene sulfonate (Kayexalate^®, Kionex^®)
Sodium zirconium cyclosilicate (Lokelma^®)

Medicines for swelling (edema)

Swelling is a common side effect of kidney disease. This happens because the kidneys are not able to excrete water as well, and it builds up in the body. Diuretics can help get rid of excess water.^1,2

Medicines for gout

Kidney disease puts you at increased risk of developing gout. Gout occurs because of a buildup of uric acid in the body. If you are dealing with gout, your doctor may prescribe you drugs that reduce uric acid buildup and help reduce the symptoms.^15,16

Drugs to treat gout may include:^15,16

Allopurinol (Aloprim^®, Lopurin, Zyloprim^®)
Febuxostat (Uloric^®)
Colchicine (Colcrys^®, Gloperba^®, Mitigare^®)
Steroids (Prednisone)

Medicines for anemia

Healthy kidneys make a hormone called erythropoietin. This hormone tells the body to make red blood cells. When kidneys are not working as they should, there is less erythropoietin. This can lead to a low red blood cell count, which is called anemia.^1,2

Anemia causes weakness and fatigue. Medicines to treat anemia include:^1,2,17

Iron supplements
Erythropoiesis-stimulating agents (ESAs) – epoetin alfa (Epogen^®), darbepoetin alfa (Aranesp^®), and others
Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) – daprodustat (Jesduvroq^®)

Daprodustat is the first HIF-PHI approved to treat anemia in CKD. It is approved for people who have received dialysis for at least 4 months. It works by triggering cells to make more erythropoietin.^17,18

Medicines for bone problems

Kidney disease increases the chance of developing bone problems, including osteodystrophy. This can make your bones weak and brittle, leading to bone breaks or fractures. The following medicines can help keep bones healthy:^1,2

Calcium supplements
Vitamin D supplements
Phosphate binders

Always check with your doctor before taking any over-the-counter supplements.

Medicines for lupus nephritis

Lupus is a chronic condition that causes inflammation in different areas of the body. When lupus affects the kidneys, it is called lupus nephritis.¹⁹

Lupus nephritis is usually treated with drugs that block the immune system. Your doctor may prescribe one or a combination of the following drugs to treat lupus nephritis:¹⁹

Steroids
Drugs that stop inflammation brought on by the immune system (immunosuppressive drugs)
Monoclonal antibodies
ACE inhibitors and ARBs
Diuretics

Other medicines to treat chronic kidney disease

Researchers have identified new medicines that could change the way CKD is treated. A few of these medicines are:^4,20-22

Icosapent ethyl (Vascepa^®) – reduces heart issues, including heart attacks, in people with advanced kidney disease
Tirzepatide (Mounjaro^®) – helps lower blood sugar
Budesonide (Tarpeyo™) – helps reduce protein levels in pee to treat Berger’s disease (IgA nephropathy)

Understanding your medicines

Before you start taking any new medicine for your kidney disease, talk with your doctor. Be sure you understand what the medicine does and how to take it. Tell your doctor or healthcare team if you have any questions or concerns.

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