| [ Summary ] |
Angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium antagonists, and diuretics are indispensable antihypertensive agents in dialysis patients. ACEIs and ARBs act on efferent arterioles in the renal glomeruli to lower glomerular pressure. These reduce the burden on the glomerulus, but a reduction in urine volume may occur due to a decrease in glomerular internal pressure, resulting in impaired removal of creatinine and electrolytes. In the case of a calcium antagonist, the influence on the kidney is due to suppression of contraction of the afferent and efferent arterioles due to a difference in the site of action. In the case of diuretics, the influence on the kidney varies depending on the site of action. Therefore, individualized drug selection based on patient characteristics becomes important. |