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How NSAIDs Impact Your Kidneys

By Doreen Ventura, MD

Nonsteroidal anti-inflammatory medications, or NSAIDs as they are commonly referred to, are often used to reduce discomfort associated with an acute injury, chronic aches and pains, fever or inflammation. NSAIDs are available over-the-counter and include aspirin, ibuprofen and naproxen sodium. Typically, NSAIDs are considered safe when used for short-periods of time, on an as-needed basis. When taken for longer periods of time and at a higher dose, NSAIDs can be harmful to the kidneys - especially for those with underlying chronic kidney disease (CKD).

In general, you should not use NSAIDs for more than 10 consecutive days for pain or more than three days for a fever. If you are experiencing lingering pain or fever, talk with your primary care provider to see if other medications may be prescribed instead.

If you have been diagnosed with CKD, you should avoid taking NSAIDs. CKD increases your risk of developing an acute kidney injury (AKI), which is a sudden worsening in kidney function. Your risk of developing AKI is higher if you are dehydrated (due to nausea, vomiting, diarrhea) or taking diuretics or medications to treat high blood pressure (ACE inhibitors and angiotensin receptor blockers). Chronic NSAID use can also accelerate the progression of CKD.

Although not very common, NSAID use can also cause a condition known as acute interstitial nephritis (AIN), which causes inflammation in your kidneys. Symptoms of AIN include a decline in energy and/or fatigue, fever, blood in your urine, nausea or vomiting. If the condition becomes chronic, your risk of developing CKD will increase.

You can reduce your risk of NSAID-induced kidney injury by following the medication guidelines below:

  • Avoid prolonged use of NSAIDs, especially those that contain more than one active ingredient.
  • Keep your doctor informed about all the medicines you take, including over-the-counter medicines, supplements and vitamins.
  • Read labels and take medications as they are prescribed.

Before taking NSAIDs, speak with your primary care provider if any of the following apply to you:

  • You have been diagnosed with high blood pressure or heart disease
  • You have kidney or liver disease
  • You take diuretic medications
  • You are over the age of 65

You may be at a higher risk of developing NSAID-related kidney disease if:

  • You take an over-the-counter NSAID that contains more than one active ingredient
  • You take six or more anti-inflammatory or pain pills daily for prolonged periods of time
  • You frequently use NSAIDs to manage chronic issues including headaches or back and other musculoskeletal pain

Kidney disease often progresses slowly, so you may not experience any immediate symptoms; however, over time as the damage to your kidneys worsens, you may begin to notice the following:

  • Feeling weak, drowsy and less alert than usual
  • Nausea and/or vomiting
  • Lack of appetite and weight loss
  • Swelling in your legs
  • Urinating less frequently

If kidney disease is suspected, your doctor will check your kidney function using a blood test. The test calculates your serum creatinine level and determines the amount of waste present in your bloodstream that would normally be filtered and removed by your kidneys. Higher creatinine levels indicate your kidneys are not effectively removing waste. Blood tests are also used to determine your glomerular filtration rate (GFR), or your current kidney function rate. If you are diagnosed with kidney disease, your primary care provider will refer you to a nephrologist (kidney specialist). Your nephrologist will work with you to develop a treatment plan to help you maintain your kidney function and avoid any further damage.

Once kidney function has been lost, it cannot be regained, so it is important to keep your kidneys as healthy as possible. You should discuss any new medications with your physician prior to starting them. Learn more about our board-certified nephrologists or call 630-873-8889 to make an appointment.


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