Painkillers and the Kidneys: Analgesic Nephropathy
An analgesic (AN-ul-JEE-zik) is any medicine intended to relieve 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 excreted only through the kidneys.
Analgesic use has been associated with two different forms of kidney damage. Some patient case reports have attributed incidents of sudden-onset acute kidney failure to the use of over-the-counter painkillers, including aspirin, ibuprofen, and naproxen. The patients in these reports had risk factors such as systemic lupus erythematosus, advanced age, chronic kidney disease, or recent heavy alcohol consumption. These cases involved a single dose in some instances and generally short-term analgesic use of not more than 10 days. Acute kidney failure requires emergency dialysis to clean the blood. Kidney damage is frequently reversible, with normal kidney function returning after the emergency is over and the analgesic use is stopped.
A second form of kidney damage, called analgesic nephropathy, can result from taking painkillers every day for several years. Analgesic nephropathy is a chronic kidney disease that over years gradually leads to irreversible kidney failure and the permanent need for dialysis or a kidney transplant to restore renal function.
Longstanding daily use of painkillers composed of two or more analgesics (particularly aspirin and acetaminophen together) with caffeine or codeine are most likely to damage the kidneys. These mixtures are often sold as powders or tablets. Recent studies have suggested that longstanding daily use of single analgesics such as acetaminophen or ibuprofen may also increase the risk of chronic kidney damage, but this evidence is not as clear.
In view of these findings, patients with conditions that put them at risk for acute kidney failure should check with their doctors before taking any analgesic medicine. People who take over-the-counter painkillers on an ongoing and regular basis should check with their doctors to make sure the drugs are not hurting their kidneys. The doctor may be able to recommend a safer alternative.
For more information
American Kidney Fund
6110 Executive Boulevard, Suite 1010
Rockville, MD 20852
Phone: 1-800-638-8299 or (301) 881-3052
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
Phone: 1-800-622-9010 or (212) 889-2210
NIH Publication No. 04-4573, April 2004
National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way, Bethesda, MD 20892-3580
The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1987, the clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases. Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.