Can Kidney Patients Use NSAIDs
Because studies have shown that NSAIDs is associated with acute and Chronic Kidney Disease (CKD), patients with CKD or at risk for CKD rarely use NSAIDs. Then, can kidney patients use NSAIDs? What to note when using them?
Can kidney patients use NSAIDs?
In the past, combined use of NSAIDs particularly two NSAIDs and caffeine, barbiturates and/or codeine has been recognized as a cause of CKD and end-stage renal disease (ESKD). However, present studies show that patients with moderate and severe CKD patients do not need to avoid using NSAIDs. Although there are some risks, but the risk is low, which is associated with accumulated toxins of drugs.
Will NSAIDs cause acute kidney injury (AKI)?
Acute renal injury (AKI) induced by NSAID is mainly caused by the vasoconstriction of the arteriole and the hemodynamic changes of GFR. Hemodynamic changes induced by prostaglandins are not clinically significant under normal physiological conditions, but are significant in cases of reduced effective circulating blood volume and/or GFR. Therefore, AKI induced by NSAID has reduced effective blood volume (such as congestive heart failure, liver cirrhosis, Nephrotic Syndrome or shock). AKI patients can be reversed within 5-7 days after stopping medicines.
Another pathogenesis of AKI induced by NSAIDs is acute interstitial nephritis (AIN). It usually occurs after 5-6 months of medications, often associated with Nephrotic Syndrome. But the incidence of AIN from NSAID is low.
How do kidney patients safely use NSAIDs?
Before using NSAIDs, creatinine, electrolytes (hyperkalemia, hyponatremia), body weight and blood pressure needs to be monitored.
Patients with a history of gastrointestinal bleeding should also use proton pump inhibitors when using NSAIDs
If you have taken ASA, you should take NSAIDs 2 hours later because COX-1 can inhibit the effect of ASA.
If patients are in a state of stress, such as acute illness, hypovolemia , fluctuation of renal function, diuretics, RAS blocker or adjustment of diuretic dose, uncontrolled blood pressure, they should not take NSAIDs.
Try to use the threshold dose for short-term use.
Periodically assess the necessity of using NSAIDs.
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***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***