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Medications to Avoid With Only One Kidney

author image Patricia Nevins, RN, MSN
Patricia Nevins is a registered nurse with nearly 20 years of nursing experience. She obtained her Master of Science in nursing with a focus in education from the University of Phoenix. Nevins shares her passion for healthy living through her roles as educator, nursing consultant and writer.
Medications to Avoid With Only One Kidney
A pharmacist is talking to a patient. Photo Credit Keith Brofsky/Photodisc/Getty Images


Although a single kidney can function adequately to meet the needs of the body, individuals with one kidney should be extra vigilant when it comes to limiting risk factors for kidney disease. Health problems like hypertension and diabetes adversely affect the kidneys. In addition, many medications cause toxic effects to the kidneys and therefore should be avoided or used with extreme caution. Medications to avoid with only one kidney include analgesics, antibiotics and contrast media used for radiographic procedures.


Many antibiotics have the potential to cause acute kidney failure or even permanent kidney failure. According to Donna D. Ignatavicius and M. Linda Workman, authors of “Medical-Surgical Nursing-Patient Centered Collaborative Care,” polymycin B, neosporin, rifampin, tetracycline, vancomycin and most sulfonamides can damage the filtering units of the kidney. Patients with only one kidney should talk with health care providers to discuss alternative antibiotic options if available. If no other antibiotic class will do the job, then patients require kidney function assessment before and during antibiotic therapy.

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Chemical Agents

Billie Ann Wilson and colleagues, authors of “Pearson Nurse’s Drug Guide 2010” report antifungal medications like amphotericin B, pesticides and radiographic contrast media can cause nephrotoxicity. Nephrotoxicity, or acute impairment of the filtering function of the kidney, is characterized by decreased urine output, blood in the urine and fluid retention. Symptoms must be caught early to prevent permanent kidney failure. Patients receiving these chemical agents during the course of medical care require close monitoring throughout therapy.

Chemotherapy Agents

Some medications used to treat cancer may damage the kidney. A patient with only one kidney will have to decide in partnership with their physician whether the benefit of the therapy outweighs the risks. Cisplatin, methotrexate and cyclophosphamide are three chemotherapy agents used alone or in combination with other anti-neoplastic medications that have the potential to cause irreversible kidney damage.

Heavy Metals

Some health problems are treated with heavy metals like gold salts and bismuth. These substances have the potential to cause renal failure. Patients require close supervision, especially those with only one kidney, while taking these heavy metals.

Pain Medications

Non-steroidal anti-inflammatory drugs like ibuprofen, naproxen, celecoxib and ketorolac are most notably associated with kidney damage when taken for long periods of time or in large quantity. However, even acetaminophen can have negative repercussions on kidney function if not taken with caution.

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  • "Pearson Nurse's Drug Guide 2010"; Wilson, B. A., Shannon, T. M., & Shields, K. M.; 2010
  • "Medical-Surgical Nursing-Patient Centered Collaborative Care"; Donna D. Ignatavicius and M. Linda Workman; 2010
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