Monday, October 8, 2018

Anti Hypertensive Agents and removal by Hemodialysis


Here is a list of common anti hypertensive agents used in ESRD and clearance via HD. In general, ACEI are removed in variable amounts, ARBs and aldo antagonists are not. Beta blockers are variable. CCB are variable but in general not that removed.


Class


%Removal with
hemodialysis
Angiotensin converting enzyme inhibitors


  Captopril


Yes
  Benazepril


20–50%
  Enalapril


35%
  Fosinopril


<10%
  Lisinopril


50%

Quinapril
  

Ramipril


 <10%( limited data)


<30%
Angiotensin receptor blockers


  Losartan


None
  Candesartan


None
  Eprosartan


None
  Telmisartan


None
  Valsartan


None
  Irbesartan


None
Aldosterone antagonists


  Spironolactonea


None
  Eplerenoneb


None
Renin inhibitor


  Aliskiren


?
β-Blockers and combined α- and β-blockers


  Atenolol


75%
  Metoprolol


High
  Metoprolol XL


High
  Propranolol


<5%
  Carvedilol


None
  Carvedilol CR


None
  Labetalol


<1%
Calcium channel blockers


  Amlodipine


None
  Diltiazem


<30%
  Nifedipine


Low
  Nicardipine


?
  Felodipine


No
  Verapamil


Low
Alpha-adrenergic blockers


  Doxazosinc


None
  Terazosin


None
  Prazosin


?
Other


  Clonidine


<5%
  Hydralazine


None
  Isosorbide dinitrate


Yes
  Minoxidil


Partially


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