The number two cause of ESRD is high blood pressure. Long-term control of blood pressure is critical to preserving kidney function. ACE (angiotensin-converting enzyme) inhibitors and a similar class of drugs called angiotensin receptor blockers (ARBs) are the best medications for controlling the condition and preventing kidney damage. These drugs protect the kidneys more than other blood pressure medicines. People with reduced kidney function and high blood pressure should try to keep their blood pressure below 130/80 mm Hg.