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Which medication class is considered first line for hypertension in CKD for reducing pressure in the glomerulus?
Beta-blockers
Calcium channel blockers
ACE inhibitors/ARBs
Diuretics
The correct answer is: ACE inhibitors/ARBs
ACE inhibitors/ARBs are considered first line medication for hypertension in CKD because they can effectively reduce blood pressure in the glomerulus, which is essential for preserving kidney function. Beta-blockers, calcium channel blockers, and diuretics may also effectively lower blood pressure, but they do not have the same beneficial long-term effects on kidney function as ACE inhibitors/ARBs. For example, beta-blockers may decrease glomerular filtration rate and calcium channel blockers may increase risk of edema, both of which can worsen kidney function in CKD patients. Diuretics can also cause dehydration, which can be harmful for those with impaired kidney function. Therefore, ACE inhibitors/ARBs are the preferred first line medication for hypertension in CKD.