- Everyday medications stashed in your cabinet could be harming your kidneys.
- These include common medications like antibiotics, blood pressure drugs, and even some supplements.
- Some people are at higher risk of kidney damage from these medications including those who are over 60 years of age or who are living with chronic conditions like diabetes, high blood pressure, and lupis nephritis.
Everyday medications that you have stashed in your cabinet could harm your kidneys if taken too often or at high doses.
In fact, 20% of kidney damage that is caused by medications applies to both prescription and over-the-counter (OTC) medications, according to the American Academy of Family Physicians.
“Most people don’t give their kidneys a second thought, but in reality, 1 in 3 people in the U.S. are at risk for kidney disease. Drug-induced kidney disease is arguably the most preventable,” HaVy Ngo-Hamilton, PharmD, clinical consultant at BuzzRx, told Healthline.
Which common medications could silently damage kidneys?
While there are many medications that can cause kidney damage, below are common ones to keep in mind.
Non-steroidal anti-inflammatory drugs (NSAIDs) treat pain and inflammation. They include aspirin (Bayer, Ecotrin), ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). These medications are among the most common culprits of drug-induced kidney disease in which long-term use can lead to chronic kidney disease (CKD).
“These medicines should never be taken every day or often without consultation with your healthcare provider first,” Emily Beckman, APRN, nurse practitioner at Norton Community Medical Associates, told Healthline.
Antibiotics, such as penicillin and cephalosporins, are given to fight infections caused by bacteria. While they are typically prescribed with the intention of finishing the entire prescription, many people don’t finish them and keep extras in their cabinets.
“Many people will try to self-medicate with ‘leftover’ antibiotics when they feel a cold coming on. Not only is this ineffective for a viral-induced cold, but may also cause acute kidney issues,” said Ngo-Hamilton.
Proton pump inhibitors (PPIs)
PPIs, such as omeprazole (Prilosec) and lansoprazole (Prevacid), help reduce stomach acid and are among the most commonly prescribed medications.
“While they have a low overall risk for kidney injury, long-term use and sustained higher doses have been found to increase the chance of kidney disease,” said Ngo-Hamilton.
Blood pressure medications
Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are effective at controlling blood pressure and reducing the risk of stroke and other cardiovascular diseases.
Some common ACEIs include benazepril (Lotensin), enalapril (Vasotec), and lisinopril (Prinivil, Zestril).
Common ARBs include azilsartan (Edarbi), candesartan (Atacand), and irbesartan (Avapro).
“You should not stop taking these medications unless your doctor tells you to,” said Ngo-Hamilton. “However, while on these medications, you should be vigilant of other medications that can be harmful for your kidneys to prevent increasing the risk of kidney injury.”
Supplements can also affect kidney function.
While not all supplements are unhealthy, Beckman suggested talking to your healthcare provider for guidance on the best way to take supplements as part of an overall health plan.
“Medicine is truly lifesaving, but we always have to be mindful of how our food intake and lifestyle make a huge difference in our overall well-being, including protecting our kidneys,” Beckman said.
Ngo-Hamilton agreed. She said the biggest concern with herbal supplements is their interaction with prescription and OTC products, and their ability to cause kidney injury.
“A common Chinese medicine containing aristolochic acid has been linked to chronic kidney injury. These herbal supplements are used to alleviate symptoms of arthritis, menstrual pain, and weight loss,” she said.
Medications used to treat mental health conditions can also cause kidney problems, such as Prozac (fluoxetine), which is a commonly prescribed antidepressant.
“Lithium and Elavil (amitriptyline), two mood stabilizers, are also potentially harmful for the kidneys. These psychiatric medications can cause muscle breakdown, leading to the release of myoglobin into the bloodstream. Since the kidneys work to filter myoglobin, kidney damage happens as a result,” said Ngo-Hamilton.
How much of these medications is too much?
Knowing how much medication is too much or what a “hard-stop” is before certain medications can cause harm to your kidneys is difficult to answer, said Ngo-Hamilton.
“Unfortunately, there is no cut-and-dried answer to that question,” she said.
Generally, for OTC products, if you take more than what’s instructed on the product label, or for an extended period of time, it may be dangerous to kidney health, she added.
For prescription medications, she said taking more than what your doctor prescribed or using leftover antibiotics, antivirals, and pain relievers, can all be harmful to the kidneys.
Who’s at the highest risk of kidney damage from medication?
Some people are at a higher risk of drug-induced nephrotoxicity (kidney damage) than others. Ngo-Hamilton said risk factors include:
- Being over 60 years old
- Having an underlying renal insufficiency that is caused by other diseases, such as high blood pressure, diabetes, and lupus nephritis
- Living with medical conditions, such as intravascular volume depletion (seen in vomiting, diarrhea, and bleeding), diabetes, and cardiovascular diseases like high blood pressure, liver dysfunction, electrolyte imbalances, and sepsis
If you are at high risk, talk with your doctor about assessing your baseline renal function before taking any medication.
“Also, ask questions about nephrotoxic drug combinations (taking more than one medication that can cause renal injury) to find out if your current medications put you at higher risk for kidney injury,” said Ngo-Hamilton.
What are signs of kidney disease?
Drug-induced nephrotoxicity can contribute to two types of kidney disease– chronic kidney disease (CKD) and acute kidney injury (AKI).
Chronic kidney disease (CKD) develops gradually over time. Along with certain medications, CKD can also be the result of a chronic condition, such as diabetes or high blood pressure, said Ngo-Hamilton.
“Most patients with CKD don’t have any symptoms in the early stages, which is why it’s known as ‘a silent killer.’ The condition is typically discovered during routine testing for unrelated problems, and a simple blood and urine test are used to diagnose CKD,” she said.
Symptoms of CKD include:
- Swelling of the lower extremities, especially the ankles
- Decrease in the amount of urine
- Confusion, shortness of breath, and seizures, if left untreated
There are 5 stages of kidney diseases and their symptoms can overlap.
“However, the signs and symptoms will worsen as the disease progresses. Stage 5 is when dialysis or a kidney transplant is necessary to continue living,” said Ngo-Hamilton.
Acute kidney injury (AKI), also called acute renal failure, is when kidney failure or kidney damage occurs suddenly within a few hours or a few days. AKI is common in people who are in the hospital, in intensive care units, and especially in older adults, according to the National Kidney Foundation (NKF).
How to prevent drug-induced kidney disease?
If kidney damage is due to medication, discontinuing the medication, replacing fluids, and treating kidney inflammation are ways to treat it.
However, none of this should be done without the direction of a physician.
“For a lot of us, taking medication for a chronic illness is not an option,” said Ngo-Hamilton, noting that more than 55 million Americans are currently taking antihypertensive drugs to maintain heart health. “All medications come with side effects, some more significant than others; most of the time, the benefits outweigh the risks.”
She suggested the following ways to avoid kidney damage from medication:
- Keep an updated list of OTC and prescription medications, and supplements you take
- Ask your doctor how each medication you take might interfere with your kidneys and if taking a new medication could cause issues
- Stay hydrated and eat a reduced salt diet that includes a lot of fruits and vegetables
- Exercise daily to control blood pressure, and in turn, reduce the risks of kidney injury
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