Alpha-blockers, commonly used to treat hypertension, was associated with a decline in eGFR in a significant number of patients with chronic kidney disease. This resulted in an increase in patients requiring dialysis or transplantation. The study also
showed alpha-blockers doing their job, however, decreasing the risk of major cardiovascular events.
Alpha-blockers are normally used as an add-on therapy, not as a first-line one. This is because of known safety and efficacy issues.
The kidneys filter the blood, removing wastes and toxins. This material is then expelled from the body through urine.
When the kidneys function at reduced capacity or are no longer functioning, the patient has chronic kidney disease. Patients then have to undergo routine hemodialysis several times a week to remove these toxins. If they are allowed to build up, they can cause damage to other organs and even organ failure.
Approximately 15% or 37 million people in the United States suffer from this condition. Nine out of ten cases go undiagnosed. In one study 381,120 adults (at least 66 years of age) were examined, all of who were receiving treatment for hypertension between 2007 and 2015.
Newly prescribed alpha-blockers (doxazosin, terazosin, prazosin) and those prescribed alternative BP-lowering medications were compared. The alternative medications were angiotensin-converting enzyme inhibitors, angiotensin II receptor
blockers, calcium channel blockers, beta-blockers, and thiazide diuretics.
Researchers found several outcomes. They included at least 30% eGFR decline; dialysis initiation or kidney transplantation. They also found a composite of acute myocardial infarction, coronary revascularization, and congestive heart failure or atrial fibrillation.
They also discovered safety (eg, hypotension, syncope, falls, fractures) events; and mortality. Because of the various results, researchers recommended closely monitoring patients using alpha-blockers.
Additionally, caution must be exercised when chronic kidney disease therapy is begun on a patient taking alpha-blockers.
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