Because renal failure, also known as kidney failure, affects many body functions, many drugs may be used depending on the type of failure and the stage of the disease. Acute renal failure, the sudden loss of kidney function, is potentially life threatening, but with treatment the kidneys usually recover full function within a few weeks to a few months. Chronic renal failure has no cure, but drug treatments can delay the disease’s progress and compensate for some of its effects on the body. Drug choices for acute renal failure depend on the causes for failure and may differ from drug treatments for chronic renal failure. In treating chronic renal failure, medications are given both to preserve remaining kidney function and to compensate for imbalances resulting from chronic renal failure. For both acute and chronic renal failure, drug choices and dosages may be modified as kidney function changes.
Diuretics
Renal failure affects the kidneys’ ability to regulate fluid and electrolyte balance, causing fluid retention. Diuretics, also known as “water pills,” increase the amount of fluid excreted through urination. According to the MayoClinic.com. These may include loop diuretics, thiazide diuretics, or potassium-sparing diuretics. Doses depend on the degree of fluid retention and the stage of disease. Once the patient has reached end-stage renal disease and requires dialysis, diuretics are usually stopped because, according to Merck Manuals Online Medical Library, dialysis is sufficient to regulate fluid retention in the body.
Blood Pressure Medications
High blood pressure and chronic renal failure are interconnected diseases. Most patients with chronic renal failure require medication to control blood pressure. According to MedlinePlus, a publication of the National Institutes of Health, physicians typically prescribe medications known as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers to control high blood pressure caused by kidney problems. Other types of blood pressure medication such as calcium channel blockers or beta blockers may also be prescribed. Patients typically try blood pressure medications in different combinations and doses to obtain effective control of blood pressure with minimal side effects.
Treating Excess Potassium
The kidney normally regulates potassium blood levels. When the failing kidney no longer excretes sufficient potassium, blood levels of potassium rise, which can cause fatal heart arrhythmias. When potassium levels are critically high, physicians may prescribe insulin and glucose to transport potassium from the blood across cell walls, explains the Merck Manuals Online Medical Library. Potassium then remains inside of cells, thereby reducing the amount of potassium in the blood. Another treatment may be Kayexelate, a medication that binds potassium so that it is excreted in the stool, according to Drugs.com.
Preventing Calcium Imbalances
Renal failure disrupts the complex balance of calcium, vitamin D, and phosphorus. Imbalances may cause weak bones and other complications. Patients may need calcium supplements, according to MedlinePlus, or depending on the disease stage, a medication that binds phosphate, such as aluminum hydroxide gel.
Treating Anermia
Patients with renal failure often lack sufficient red blood cells, a condition called anemia, because their kidneys no longer make enough erythropoietin, a hormone that triggers the production of red blood cells. Medications such as Epogen or Procrit, laboratory versions of erythropoietin, may be prescribed, the MayoClinic.com notes, and iron supplements may be given as well.
Drugs for Acute Renal Failure
Acute renal failure can arise from many causes, including trauma, infection, toxins, or other conditions. Whether acute renal failure is caused by direct damage to the kidney or another condition, drug treatment addresses the underlying cause while supporting blood circulation in the kidneys, says the MayoClinic.com. When acute renal failure is caused by decreased blood flow to the kidneys, as in shock, heart failure, or sepsis, patients may be given intravenous fluids along with diuretics, medications that trigger the kidneys to pull water from the blood and excrete it as urine. This combination increases renal circulation and “flushes” the kidneys. However, in cases when acute renal failure causes fluid overload, intravenous fluids will be withheld, and diuretics will be prescribed to encourage fluid loss. Along with medications to mange fluid and electrolyte balance, patients with acute renal failure may be treated with antibiotics, steroids, or other medications, depending on the causes of failure.
