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And, just for your information.


10 Medications That May Raise Your Risk of Kidney Damage



1. NSAIDs, like ibuprofen

Nonsteroidal anti-inflammatory drugs (NSAIDs) are popular remedies for pain and fever. And they’re widely used to treat a host of health conditions, such as rheumatoid arthritis, menstrual pain, and inflammation. 

Some common NSAIDs are:

While NSAIDs have many uses and are generally well-tolerated, taking them also poses some risks. These medications can affect blood flow through the kidneys, which can contribute to kidney damage or failure. People with heart failure, liver disease, or existing kidney problems are at a higher risk for experiencing new or worsening kidney problems related to NSAIDs.

In general, it’s best to take NSAIDs sparingly, at their lowest effective dose, and for the shortest period of time possible. Occasional doses of NSAIDs taken in recommended amounts are much less likely to cause kidney damage.


2. Diuretics, like hydrochlorothiazide

Diuretics, or water pills, treat health conditions such as high blood pressure and heart failure. Popular diuretics include:

These diuretics are typically well-tolerated but, as with all medications, they can cause side effects. Diuretics are associated with a risk of acute kidney injury, especially in older adults. This is likely because diuretics lower blood volume, which disrupts the filtration process.

Kidney damage is more likely with higher doses of diuretics.


3. ACE inhibitors, like lisinopril

Angiotensin-converting enzyme (ACE) inhibitors can be good and bad for your kidneys. These medications are easily identifiable because they end in “-pril,” such as:

ACE inhibitors are go-to medications for managing high blood pressure and heart failure. And in these conditions, they can also protect the kidneys. But ACE inhibitors are cleared out of the body through the kidneys, so they also carry a risk of causing kidney injury.

You’re more likely to experience kidney problems related to an ACE inhibitor if you’re dehydrated or taking other nephrotoxic medications. In either case, you will likely start on a lower dose. Your healthcare provider may also recommend that you come in for routine blood tests to monitor your kidney health over time.


4. Iodinated radiocontrast

Although it sounds like a complicated term, iodinated radiocontrast refers to contrast dyes used during radiographic testing, such as a CT scan. The dyes make your organs and blood vessels more visible during the scan.

The downside is that iodinated radiocontrast agents can lead to kidney injury. This type of kidney injury usually appears within 24 to 48 hours of receiving the contrast. And the risk factors include existing chronic kidney disease, diabetes, having low blood volume, and taking other nephrotoxic medications. 

For people who are at risk of kidney injury from radiocontrast dyes, providers will often lower the amount that is used during a test.


5. Vancomycin

Vancomycin is an antibiotic used to treat serious methicillin-resistant Staphylococcus aureus (MRSA) infections. It’s frequently used in hospital settings.

Kidney damage from vancomycin usually happens within 4 to 17 days after beginning treatment with the medication. And kidney function usually improves after treatment is stopped. Pharmacists and prescribers in the hospital work together to closely monitor you and your vancomycin dose every time it’s administered.


6. Aminoglycoside antibiotics, like gentamicin

Aminoglycoside antibiotics, when given as an IV infusion, are known for causing kidney injury. People with chronic kidney disease, who are dehydrated, or who have been taking these antibiotics for longer than 10 days are at particularly high risk for this side effect. 

Common IV aminoglycoside antibiotics include:

These medications are typically only used in hospital settings, which allows for close monitoring during treatment. A healthcare provider may adjust a person’s dose to be less harmful to their kidneys depending on their medical history and treatment response. 


7. HIV medications, like Truvada

Certain HIV medications have been linked to kidney damage. Tenofovir disoproxil fumarate (Viread) — on its own and in combination products like Truvada and Stribild — can cause acute kidney injury in certain situations. The same goes for atazanavir (Reyataz).

It’s important that anyone planning to take one of these medications should first be screened for kidney problems. If a person has kidney problems, they may need to take a lower dose for safety purposes. 

Not all HIV medications carry this risk. For instance, the newer formulation of tenofovir, tenofovir alafenamide (Vemlidy), is less likely to cause kidney toxicity. This is also true for tenofovir alafenamide combination products, like Descovy and Biktarvy.


8. Other antiviral medications

Some other antiviral medications, like acyclovir (Zovirax) and ganciclovir, can also cause kidney injury. These medications can produce crystals that do not dissolve in urine. These crystals can cause blockages in your filtration system. This side effect is more likely to affect people who are dehydrated or have existing kidney disease.

Foscarnet is another nephrotoxic medication that treats viral infections. It’s not a commonly prescribed medication, but it can cause kidney damage rather easily. So, if you need it, your healthcare provider will closely track your kidney function.


9. Zoledronic acid

Zoledronic acid (Reclast) belongs to a group of medications called bisphosphonates, which are used to treat osteoporosis. Kidney damage is a rare but serious side effect associated with zoledronic acid. And the FDA issued a formal warning regarding the risk.

In general, Reclast generally shouldn’t be given to people with abnormal kidney function or preexisting kidney damage. This is also true for Zometa, another version of zoledronic acid used to treat high calcium levels that can occur with certain types of cancer.


10. Calcineurin inhibitors, like tacrolimus

Calcineurin inhibitors, like cyclosporine modified (Neoral) and tacrolimus (Prograf), are  immunosuppressants commonly prescribed to people who have had an organ transplant. These medications have the potential to cause kidney damage.

The benefits of these life-saving medications often outweigh the potential risk of kidney damage, but it’s still good to keep in mind. The risk of kidney damage related to cyclosporine or tacrolimus is worse with higher doses and in people who are already at risk of kidney damage. If you take either of these medications, your healthcare provider will likely monitor your kidneys. 


When should I see a healthcare provider about suspected kidney problems from my medication?

It’s not always easy to tell if you have kidney damage. You might not experience any symptoms at all. And your healthcare provider may only notice signs of it after running certain lab tests. 

But if you do notice any of these symptoms, talk to your healthcare provider right away:

  • Blood or foam in the urine

  • Dark colored urine

  • A noticeable change in urinary frequency 

  • Lower back or flank pain

  • Decreased or difficulty urinating

If you report any of these side effects, your healthcare provider will likely order lab tests to evaluate your kidney health. Based on these results and what medications you are taking, you may need to stop or pause treatment. In some cases, you may be able to switch to a medication that is safer for your kidneys.


 

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