Kidney Damage from Painkillers

Kidney Health Care - David Mangusan Jr, PTRP

Analgesics: The Effect on the Kidneys.

Two different forms of kidney damage, acute renal failure and analgesic nephropathy, have been associated with analgesic use.

Analgesics are medicines intended to relieve pain. Over-the-counter (OTC) analgesic drugs are painkillers that are available without a prescription. OTC painkillers may include acetaminophen, ibuprofen, and naproxen sodium. Although these drugs present no danger for most people when taken in their recommended dosage, some of these common painkillers may be dangerous for the kidneys when used improperly. Other conditions can make taking these drugs damaging to the kidneys as well.

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Acute Kidney Failure

Acute kidney failure is the sudden and temporary loss of kidney function. Some case reports have attributed incidents of acute kidney failure to the use of OTC painkillers, including aspirin, ibuprofen, and naproxen sodium. Some patients in these reports had risk factors such as:
 Systemic lupus erythematosus

 Advanced age

 Chronic kidney disease

 Recent heavy consumption of alcohol
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Analgesic Nephropathy

Analgesic nephropathy, a form of chronic kidney disease, results from long-term or chronic use of painkillers. That is, taking painkillers everyday for several years. Chronic use of analgesics can gradually cause irreversible kidney damage, which may eventually lead to kidney failure. Total kidney failure, or end-stage renal disease, requires dialysis or kidney transplantation to maintain life.

Experts estimate that four out of 100,000 people will develop analgesic nephropathy. The disease is more common in women over 30 years of age.

People who take painkillers or pain relievers regularly should talk to their doctor to make sure the drugs are not damaging their kidneys. Also, people with conditions that put them at risk for acute kidney failure should check with their physician before taking any OTC analgesic medicines.

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Treatment

Treatment may include:
 Discontinuation of analgesic use

 Emergency dialysis. People with analgesic-related acute kidney failure may require dialysis to clean the blood. Kidney damage is frequently reversible.

 Dietary changes

 Medications to avoid anemia and bone problems caused by kidney disease

 Practice of alternative methods of controlling chronic pain such as behavior modification or relaxation techniques.
Goal of treatment focuses on preventing or delaying the onset or progression of kidney damage. If some kidney damage has occurred, have your doctor monitor your kidney function with regular urine and blood tests.

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References:

National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008

National Kidney and Urologic Diseases Information Clearinghouse. Analgesic Nephropathy (Painkillers and the Kidneys). National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–4573, September 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/analgesicnephropathy/index.htm. Accessed July 2008


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