Analgesic Nephropathy

An analgesic (AN-ul-JEE-zik) is any medicine intended to kill pain. Over-the-counter analgesics (medicines bought without a prescription) include aspirin, acetaminophen, ibuprofen, naproxen sodium, and others. These drugs present no danger for most people when taken in the recommended dosage. But some conditions make taking even these common painkillers dangerous for the kidneys. Also, taking one or a combination of these drugs regularly over a long period of time may increase the risk for kidney problems. Most drugs that can cause kidney damage are the ones that are excreted only through the kidneys.

Numerous reports attribute incidents of acute kidney failure to the use of painkillers, including aspirin, ibuprofen, and naproxen. The patients in these reports had risk factors such as systemic lupus erythematosus, advanced age, chronic renal conditions, cirrhosis or heart failure. In rare cases, these involved a single dose but they never more than 10 days of analgesic use. When acute kidney failure does occur, it requires emergency dialysis to clean the blood. But normal kidney function often returns after the emergency is over.

A different kind of problem can result from taking painkillers every day for several years. Analgesic nephropathy is a chronic kidney disease that can sometimes lead to end-stage renal disease and the permanent need for dialysis or a kidney transplant to restore renal function. In addition, chronic aspirin use in recommended doses, while its an NSAID, does not cause analgesic nephropathy by itself.

The painkillers that combine two or more analgesics (for example, aspirin and acetaminophen together) with caffeine or codeine are most likely to damage the kidneys. These mixtures are often sold as powders. Single analgesics (e.g., aspirin alone) have not been found to cause kidney damage. 

Patients with conditions that put them at risk for acute kidney failure should check with their doctors before taking any medicine. People who take painkillers on a regular basis should check with their doctors to make sure they are not hurting their kidneys. The doctor may be able to recommend a safer alternative.

For More Information

Contact the following organizations:

American Kidney Fund
11921 Rockville Pike, Suite 300
Rockville, MD 20852
(800) 638-8299
Home page: http://www.kidneyfund.org

National Kidney Foundation
30 East 33rd Street
New York, NY 10016
(800) 622-9010
Home page:http://www.kidney.org

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Additional Information on Analgesic Nephropathy

The National Kidney and Urologic Diseases Information Clearinghouse collects resource information on kidney and urologic diseases for the Combined Health Information Database (CHID). CHID is a database produced by health-related agencies of the Federal Government. This database provides titles, abstracts, and availability information for health information and health education resources.

To provide you with the most up-to-date resources, information specialists at the clearinghouse created an automatic search of CHID. Or, if you wish to perform your own search of the database, you may access the CHID Online web site ( http://chid.nih.gov ) and search CHID yourself.

WebMD Public Information from the U.S. National Institutes of Health

Sources

The National Institute of Diabetes and Digestive and Kidney Diseases of The National Institutes of Health. Analgesic Nephropathy (Painkillers and the Kidneys). NIH Publication No. 99-4573. Last updated October 2, 1998. (Online) http://www.niddk.nih.gov/health/kidney/summary/analgesc/index.htm

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