Comparison of suggested first-, second-, third-, and fourth-line drug choices for hypertension in predialysis CKD versus ESKD on dialysis
| Prescribing Order | Drug Class in CKD | Drug Class in Dialysis | Comments |
|---|---|---|---|
| First | ACEi or ARB | BABA | Atenolol is long acting and effective for hypertension on dialysis |
| Second | DHP-CCB or diuretic | DHP-CCB | DHP-CCBs are effective and widely available |
| Third | Diuretic or DHP-CCB | ACEi or ARB | No established role for diuretic in dialysis |
| Fourth | MRB | Direct vasodilator | Evidence for MRB for resistant hypertension in non-CKD population |
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; BABA, β-adrenergic blocking agent; DHP-CCB, dihydropyridine calcium channel blocker; MRB, mineralocorticoid receptor blocker.