Top Recommendation 3 – Avoid NSAIDs

The prior two posts presented two of the five top recommendations of the American Society of Nephrology (ASN).  These recommendations will serve as a basis for discussions between doctor and kidney patient to raise awareness and improve care.   The third top recommendation of the ASN is to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) in individuals with hypertension or heart failure or kidney disease from any cause, including diabetes.

NSAIDs include such products as aspirin, ibuprofen, Actron, Advil, Aleve, Alka-Seltzer, Bayer, Excedrin, Nuprin, Medipren, Motrin-IB, Pedicare Fever, and a host of other related drugs.  Check the drug’s ingredients label or ask the pharmacist, if you are unsure whether the product contains NSAIDs.

The ASN indicates that NSAIDs are the most frequently used medications for osteoarthritis and mild to moderate pain, but they cause many negative effects on the kidney, even if you have normal kidney function.  NSAIDs can cause salt retention, acute allergic interstitial nephritis, and nephrotic syndrome.  They can cause acute kidney injury, an imbalance in potassium, and a decreased glomerular filtration rate.  Kidney patients who take ACE-inhibitors or related antihypertensive drugs are at a very high risk for damage from NSAIDs.

Moreover, data show that taking NSAIDs over a long period results in the drug accumulating in the body and is associated with a rapid progression of kidney disease in the elderly, who are particularly vulnerable to harm from drugs.  NSAIDs also increase blood pressure and make patients more resistant to the effects of their antihypertensive medication.  NSAIDs increase the risk of heart failure.

Because of the serious risks to kidney patients, their doctors need to talk with them about the negative effects of NSAIDs and eliminate their use or find acceptable alternatives.  Has your doctor warned you about NSAIDs?

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