DRUG USED FOR CHRONIC KIDNEY PATIENTS

Actually there is no cure for chronic kidney disease, but we can treat the signs and symptoms, reduce the risk of complications and slow the disease. Treatment for kidney disease can use medications such as:

MEDICATION TO RELIEF ANEMIA	LOWER CHOLESTEROL MEDICATION	MEDICATION TO RELIEF SWELLING	MEDICATION TO PROTECT BONE	HIGH BLOOD PRESSURE MEDICATION
Supplement erythropoietin or plus iron	-statin -fibrates -niacin -omega 3 fatty acid	-diuretic	-calcium and vitamin D supplement	- ACE inhibitors - angiotensin II receptor blockers. -Beta blocker -Calcium channel blocker. - Direct renin inhibitor - diuretics

beside drug, supplement such as vitamin and mineral also can be used for renal patient.

SUPPLEMENT FOR CHRONIC KIDNEY PATIENTS.

Here are the types of vitamins and minerals that are given to patient’s chronic kidney disease:

VITAMIN / MINERAL	LEVEL
Calcium carbonate	500 mg
Ferum fumarate	200 mg
Folate	5 mg
Vitamin C	50 mg
Vitamin B complex	Aneurin 1 mg Riboflavin 1.5 mg Nicotamide 10 mg
Neurobion	Vitamin B1 100mg B6 200mg B12 200 mg
Vitamin D	Alfacalcidol 0.25 mcg Calcitriol 0.25 mcg

Sumber: hospital Kuala Lumpur 2004

DRUG USED FOR END STAGE RENAL FAILURE

• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers –prescribe to lower the blood pressure hence preserve the kidney. Hypertension decreases the kidney function & cause electrolytes imbalance. This medication not only reduce blood pressure but slow down the loss of kidney function as well

• Statins medication- prescribes to lower the blood cholesterol level. Patient with Kidney failure usually experience high level of LDL cholesterol that lead to heart disease

• Erythropoietin-stimulating agents- medication that used to relive anemia by induce production of RBC which can resolve fatigue and weakness associated with anemia. ESAs mimic the erythropoietin hormone that helps body produce RBC. Usually taken with extra iron intake.

• Diuretic medication-prescribe to relieve swelling or water retention that called edema. Diuretic help maintain the balance fluids in the body by help rid the body of excess fluid. Side effect: dizziness, frequent urination.

• Vitamin D & calcium supplement-To protect the bones from bone disease by prevent the bones from weak and lower risk of fracture. Abnormalities of Vitamin D are common in ESRF due to failure of kidney to convert vitamin D to active form that body can utilize.

• Phosphate binder medication- lower the amount of phosphate in the blood(hyperphosphatemia) is common in ESRD) thus increase the amount of calcium available in the bones. Phosphate binder work by absorbing excess amount of phosphorus from ingested food. Example of phosphate binder is sevelamer.

• Cinacalnet HCL(sensipar)-effective in lowering the elevated parathyroid hormone level. Taken by orally. Give several side effect such nausea, vomiting and transient low blood calcium level.

• Sodium Bicarbonate-prescribe with development of metabolic acidosis. Taken by orally with certain precautions since the medication increase the sodium level.