UAB Medicine News

Chronic kidney disease (CKD) is a medical condition that causes a gradual loss of kidney function over time. More than 40 million Americans and 850 million people worldwide have CKD, sometimes known as chronic renal disease. It is most commonly related to diabetes and high blood pressure, though it can be caused by other disorders, too.

In addition, certain medications known as nephrotoxins can damage the kidneys and possibly lead to chronic kidney disease, or make an existing kidney condition worse. No matter how they are introduced into the body, medications pass through the kidneys. Therefore, patients should note each medication’s risks, observe the guidelines on the label, and follow a health care provider’s instructions. This is especially important with medications that specifically mention the potential of kidney damage. People with existing kidney conditions or damage are at much greater risk of harm by nephrotoxic medications.

Below are basic details about medications that may negatively affect your kidneys. As with any health information, it should be considered only in addition to your doctor’s advice.

Pain Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the drugs most frequently associated with kidney damage because of their widespread use. NSAIDS such as Naproxen, ibuprofen, Aleve, Advil, and Motrin are used to treat inflammation, fever, rheumatoid arthritis, menstrual pain, and much more. NSAIDs may reduce the amount of blood flow to the kidneys, resulting in a higher risk for damage or failure. Using NSAIDs at the lowest effective dose for the shortest duration can reduce that risk.

Acetaminophen remains the drug of choice for occasional use in patients with CKD, to avoid bleeding complications that may occur when these patients use aspirin. However, people with kidney conditions who need to use acetaminophen habitually should be supervised by their doctors and avoid drinking alcohol while on this medicine.

Aspirin, taken as directed, does not increase the risk of CKD in people with normal kidney function. However, extreme doses (usually more than 6-8 tablets a day) may temporarily or even permanently reduce kidney function. Aspirin may increase the tendency to bleed for patients with CKD. Those who already have reduced kidney function, or other health problems such as liver disease or severe heart failure, should not use aspirin without speaking to their doctor.

Antibiotics

Antibiotics also can be dangerous to the kidneys if not taken correctly. Patients with CKD should speak to their physician about smaller-than-normal dosages of antibiotics.

Prescription Laxatives

In general, over-the-counter laxatives are safe for most people. However, some prescription laxatives that are used for cleaning the bowel (usually before a colonoscopy) can harm the kidneys. Patients with CKD who use bowel cleansing products should be aware of a recent warning issued by the U.S. Food & Drug Administration (FDA) about a type of sudden loss of kidney function or acute kidney injury, as well as blood mineral disturbances, that these products can cause.

Contrast Dyes

Diagnostic imaging tests such as MRIs, CT scans, and angiograms may require the use of an injected contrast dye that is used to enhance the images, but sometimes those dyes can lead to kidney problems or cause problems in patients with kidney disease. Patients undergoing such tests should inform health care professionals about any kidney disorders they have. Patients also should discuss risks and precautions with the doctor ordering the diagnostic test, the radiologist, the radiology technician, and the nurse.

Diuretics

Diuretics help body release excess salt and water. These medications are used to treat conditions such as high blood pressure, glaucoma, and edema (swelling). Many diuretics affect how the kidneys regulate water in the body, which can lead to worsening kidney function and abnormal electrolyte levels. Your health care providers can help determine which diuretics are right for you.

March is National Kidney Month, a good time to expand your knowledge of issues that may affect kidney health. Click here for more information about treating and preventing kidney disease.