Table 2.

Comparison of suggested first-, second-, third-, and fourth-line drug choices for hypertension in predialysis CKD versus ESKD on dialysis

Prescribing OrderDrug Class in CKDDrug Class in DialysisComments
FirstACEi or ARBBABAAtenolol is long acting and effective for hypertension on dialysis
SecondDHP-CCB or diureticDHP-CCBDHP-CCBs are effective and widely available
ThirdDiuretic or DHP-CCBACEi or ARBNo established role for diuretic in dialysis
FourthMRBDirect vasodilatorEvidence 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.