GPs are given four quality framework points for managing hypertensive CKD patients with ACE inhibitors or angiotensin receptor blockers (ARBs).
But these drugs should only be given to patients younger than 55, according to the Royal College of Physicians of Edinburgh.
Dr Stuart Rodger, a consultant nephrologist in Glasgow, said: ‘The consensus statement said it was dangerous among the elderly in whom side-effects are more likely to occur. ACE inhibitors and ARBs should be restricted to those with proteinuria.’
Giving these patients thiazide diuretics would be in accordance with the joint guidelines on hypertension issued by NICE.
If BP is controlled, GPs should exemption report CKD patients without proteinuria from treatment with ACE inhibitors or ARBs, he added.