Cystic Diseases of the Kidney Medication

Updated: Feb 01, 2021
  • Author: Thomas Patrick Frye, DO; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Medication

Medication Summary

No specific medical therapies are available for the renal cysts themselves. Complications of cystic renal diseases, such as hypertension, infection, and pain, are treated with standard medical therapy. Some examples are listed below.

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Angiotensin-converting enzyme inhibitors

Class Summary

These agents reduce aldosterone secretion.

Lisinopril (Zestril, Prinivil, Qbrelis)

Prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, resulting in lower aldosterone secretion.

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Angiotensin II receptor antagonists

Class Summary

These agents antagonize the effects of angiotensin II.

Losartan (Cozaar)

Nonpeptide angiotensin II receptor antagonist that blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II. May induce a more complete inhibition of the renin-angiotensin system than ACE inhibitors, does not affect the response to bradykinin, and is less likely to be associated with cough and angioedema. For patients unable to tolerate ACE inhibitors.

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Calcium channel blockers

Class Summary

In specialized conducting and automatic cells in the heart, calcium is involved in the generation of the action potential. The calcium channel blockers inhibit movement of calcium ions across the cell membrane, depressing both impulse formation (automaticity) and conduction velocity.

Diltiazem (Cardizem, Tiazac, Matzim LA, Taztia XT, Cartia XT)

During depolarization, inhibits calcium ions from entering the slow channels and voltage-sensitive areas of vascular smooth muscle and myocardium.

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Antimicrobials

Class Summary

These agents are used to treat renal parenchymal infection (to be used in combination with gentamicin) and infected renal cysts.

Ampicillin

Bactericidal activity against susceptible organisms. Alternative to amoxicillin when patients are unable to take medication orally. Used to treat parenchymal infection.

Gentamicin

Aminoglycoside antibiotic for gram-negative coverage. Used in combination with both an agent against gram-positive organisms and one that covers anaerobes. Not the DOC, but consider if penicillins or other less toxic drugs are contraindicated, when clinically indicated, and in mixed infections caused by susceptible staphylococci and gram-negative organisms. Dosing regimens are numerous; adjust dose based on CrCl and changes in volume of distribution. May be administered IV/IM.

Sulfamethoxazole and trimethoprim (Bactrim, Bactrim DS)

Inhibits bacterial growth by inhibiting synthesis of dihydrofolic acid. Antibacterial activity of TMP-SMZ includes common urinary tract pathogens, except Pseudomonas aeruginosa. Used to treat infected renal cyst.

Ciprofloxacin (Cipro)

Fluoroquinolone with activity against pseudomonas, streptococci, MSSA, S epidermidis, and most gram-negative organisms, but no activity against anaerobes. Inhibits bacterial DNA synthesis and, consequently, growth.

Used to treat infected renal cyst either in patients intolerant to or not adequately covered by trimethoprim-sulfasalazine.

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Thiazide diuretics

Class Summary

These agents are beneficial in the treatment of fluid retention.

Hydrochlorothiazide (Microzide)

Inhibits reabsorption of sodium in distal tubules, increasing excretion of sodium and water, as well as potassium and hydrogen ions.

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Analgesics

Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who experience pain.

Oxycodone and acetaminophen (Percocet, Endocet, Xartemis XR, Primlev)

Drug combination indicated for the relief of moderate-to-severe pain.

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