NSAIDs are non-steroidal anti-inflammatory drugs that are generally prescribed for mild to moderate pain. This category of drugs includes aspirin, ibuprofen, acetaminophen, naprosyn and other other-the-counter and prescription drugs. Warnings about the effect of NSAIDs on the kidneys have been circulating ever since 1990 when researchers at Johns Hopkins first published a study showing the potential danger of these drugs. Since that time, much has been learned about the specific effects that NSAIDs exert on renal tissue. A 2002 paper in the "Annals of Internal Medicine" documents that acute renal failure, electrolyte abnormalities, nephrotic syndrome, interstitial nephritis, and papillary necrosis are among the dangers of NSAIDs on the kidneys.
Acute Renal Failure
UptoDate.com reports that nonsteroidal anti-inflammatory drugs can induce two different forms of acute renal failure: hemodynamically-mediated and acute interstitial nephritis. Hemodynamically-mediated acute renal failure means there is a decline in hydraulic pressure at the glomeruli, or filters, of the kidneys. Interstitial nephritis means that the area outside the renal tubules is inflamed. UptoDate.com adds that both can be accompanied by nephrotic syndrome. Patients with nephrotic syndrome have blood in the urine and are endemic because their urine protein is so high.
Renal Papillary Necrosis
Renal papillary necrosis is seen with analgesic nephropathy. According to MedlinePlus, renal papillary necrosis is a disorder of the kidneys in which all or part renal papillae die. The renal papillae is the area where the openings of the collecting ducts enter the kidney. Cells in this region become necrotic and start to die off.
Electrolyte Abnormalities
The electrolyte abnormalities as discussed in the 2002 issue of the "Journal of Pharmacy Practice" are common to all acute and chronic kidney diseases, regardless whether they are caused by NSAIDs. For example, the Merck Manual notes that abnormalities with potassium, sodium, calcium and phosphorus are common with impaired kidney function. Abnormalities with these electrolytes can cause cardiac arrhythmias and other serious consequences.
References
- "Annals of Internal Medicine": Renal Effects of Ibuprofen, Piroxicam, and Sulindac in Patients with Asymptomatic Renal Failure
- "Journal of Pharmacy Practice"; The Renal Effects of Traditional Nonsteroidal Anti-Inflammatory Agents Versus Cyclooxygenase-2 Inhibitors
- Up to Date: NSAIDs: Acute Kidney Injury (Acute Renal Failure) and Nephrotic Syndrome
- Medline Plus: Papillary Necrosis
- Merck Manual: Problems With Electrolyte Balance
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