Some medications are nephrotoxic, which means that they have an elevated risk for harming the kidneys. In the worst case, the drug causes kidney failure, while in other cases, the kidneys are damaged, but don't fail. The most common nephrotoxic drugs are nonsteroidal anti-inflammatory drugs (NSAIDs), some antibiotics, some painkillers, and radiocontrast dye used for some imaging procedures. According to pharmacist Timothy V. Nguyen, medication-induced kidney injury may occur in as many as 70 percent of elderly people. Some people take two or more nephrotoxic drugs, increasing the risk of kidney damage.
Many medications are excreted by the kidneys, and if a person already has chronic kidney disease, the dosage may need to be adjusted down; however, many people with chronic kidney disease have no symptoms and don't realize they have kidney disease. As a result, individuals taking potentially nephrotoxic drugs should have their kidney function evaluated by their physicians.
NSAIDs
NSAIDs are medications used to decrease pain and inflammation and may be over-the-counter (OTC), or prescribed medications. Ibuprofen and naproxen are over-the-counter NSAIDs, while there are many examples of prescribed NSAIDs. According to Hannah R. Howell and colleagues, as many as 5 percent of patients taking NSAIDs develop renal toxicity and must be admitted to hospitals. Those taking high dosages of NSAIDs, as well as the elderly and patients with other health problems, have the highest risk for nephrotoxicity from NSAIDs.
Antibiotics
Most forms of penicilllin as well as all antibiotics that are cephalosporins may be harmful to the kidneys. In addition, if the kidneys are already weak, some antibiotics can harm them further, such as nitrofurantoin. People who take antibiotics on a regular basis should have their kidney function checked.
Painkillers
Many people take aspirin or acetaminophen for minor or moderate pain, while some people take narcotics for severe pain. When used on a regular basis, painkillers can damage the kidneys. For example, a small percentage of those who take high doses of acetaminophen (1 to 2 percent) develop renal insufficiency, according to Mazer and Perrone.
Many prescribed and OTC combination drugs include aspirin or acetaminophen, and it is best to know the ingredients of all drugs.
Diuretics
Diuretics, sometimes called water pills, decrease the fluid in the body . If used often and/or to excess, they may cause an imbalance of electrolytes, which can be harmful to the kidneys.
Radiocontrast dyes
Radiocontrast dyes are used in some imaging procedures to highlight an area under study; however, radiocontrast dyes can harm the kidneys and should be used only in moderation.
References
- U.S. Pharmacist, "Timothy V. Nguyen", "Practical Assessment Tools for Identifying Kidney Disease" 2010.
- U.S. Pharmacist. "Hannah R. Howell, M.L. Brundige, and Lindsay Langworthy", "Drug-Induced Acute Renal Failure", 32, 2007:45-50.
- American Family Physician. "Cynthia A. Naughton", "Drug-induced Nephrotoxicity" 78, 2008.
- Journal of Medical Toxicity. "M. Mazer and J. Perrone". "Acetaminopen-Induced Nephrotoxicity: Pathophysiology, Clinical Manifestatons, and Management." 4. 2008.
