They can be found in many medicine cabinets and are said to help those affected with headaches or infections, for example. But some of these everyday drugs can be tricky — and attack the kidneys. FITBOOK explains which drugs are involved and who is particularly at risk.
Aspirin, ibuprofen, antibiotics or antihypertensives – most of us have probably already taken one or more of these remedies when we have symptoms. The latter alone are normal in many German households. After all, it is estimated that every third person in Germany suffers from high blood pressure.1 But caution is advised. Because where the drugs help in one place, they can cause damage elsewhere – namely to the kidneys. This is what studies and experts point out.
who are particularly at risk
People over the age of 60 and people with health problems are particularly at risk of suffering kidney damage from drugs. The preexisting include those who already have renal insufficiency or diseases such as volume depletion2diabetes, heart failure or blood poisoning.3
But people who do not belong to these risk groups can also be at risk if they take medication for too long or in too high a dose. Taking non-prescription medication without first seeking medical advice is also risky.
Also interesting: 5 foods that are healthy for the kidneys
Possible signs that medication has damaged the kidneys
Medications can promote kidney disease or even cause damage to the kidneys. This can manifest itself through a variety of symptoms.4 Which ones depend on the drugs that damaged the kidneys and the type of kidney damage.
- Tiredness, exhaustion, general feeling of illness
- water retention
- shortness of breath
- Reduced urination, resulting in fever and urinary tract infections
- drop in blood pressure
- tachycardia
- cardiac arrhythmias
- Pale, sickly appearance
- hair loss
- tremors
- cramps
Also interesting: 4 medicines that were discovered by chance – and today it is impossible to imagine life without them
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that have anti-inflammatory, fever-reducing and pain-relieving effects. These include popular active ingredients such as acetylsalicylic acid (ASA), which is found in aspirin, ibuprofen and diclofenac.5 According to research, drugs with these active ingredients affect the function of the kidneys and can lead to kidney damage, especially if additional risk factors are present.6
A study from 2019 was also able to show that not only older people or people with previous illnesses are at risk of drug-related kidney damage – but also middle-aged people who are physically active. It should be noted that they were taking high doses of NSAIDs.7
Also interesting: Combinations of ibuprofen and certain medications can permanently damage the kidneys
Antibiotics
According to research, antibiotics are responsible for many cases of kidney damage caused by drugs – not only, but especially in the treatment of illnesses in hospital.8,9 Therefore, when administering the medication, attention is paid to the effect on the kidneys.
Also interesting: 35,000 deaths annually from antibiotic resistance
Gastrointestinal Drugs
Proton pump inhibitors, which include the active ingredients omeprazole and lansoprazole, are also associated with kidney damage.9,10 A study was able to show that they increase the risk of chronic kidney disease.11
Proton pump inhibitors reduce the secretion of gastric acid and are used in a variety of diseases and disorders. This includes:12
- Inflammation of the stomach lining (gastritis)
- reflux disease (inflammatory disease of the esophagus)
- ulcer of the gastric mucosa
- To protect the stomach during long-term therapy with the aforementioned NSAIDs.
blood pressure medication
Blood pressure drugs, including ACE inhibitors, which help with high blood pressure and heart failure, are among drugs for which there are few alternatives. This means that patients who depend on them cannot simply stop taking them – even if, according to research findings, they can lead to kidney damage.13
Precisely because many patients simply cannot take these drugs, understanding the effects of the drugs is all the more important. Maria Luisa Sequeira-Lopez, from UVA’s Department of Pediatrics and Child Health Research Center, said in a statement about the study: “Our studies show that renin-producing cells are responsible for the damage. We are now focused on understanding how these cells, so important in protecting us from hypotension and maintaining our well-being, undergo such conversion and cause kidney damage. We have to find out what substances these cells produce that lead to uncontrolled vascular growth in the kidneys.”14
More articles on medication
dietary supplements
In addition to medicines, other active ingredients can also be harmful to the kidneys. Anyone who takes food supplements, for example, should pay close attention to the ingredients. Since they can also interact with medications, it is also important to inform the doctor prescribing a medication that you are taking the supplement. A meta-analysis found out which active ingredients in dietary supplements you should look out for.15 The following can damage the kidneys:
- Chrompicolinat
- willow bark
- Pennywort
- Hydrazinsulfat
- aristolochic acid
- heavy metals
assessment of a physician
FITBOOK has at dr medical Matthew Riedl, internist and nutritionist with a focus on diabetology at the medical center Medicum Hamburg. He also knows about possible connections between medication and damaged kidneys. He explains to us: “Side effects can rarely occur right from the first dose. Kidney damage is more common after long-term use. This is especially true for painkillers. Here the risk increases extremely with the dose and the duration of use. The reason: the renal blood flow is reduced and in extreme cases this promotes kidney failure. Recreational athletes who do intensive sports such as marathons are particularly at risk. However, there are also cases of top athletes who have been given such drugs in high doses over a long period of time under medical supervision.”
In addition to the dosage, the combination of different drugs also plays a role in the risk of damage. “With more than five different drugs, it is becoming increasingly difficult to assess side effects or interactions,” emphasizes Riedl. In general, the doctor advises people with existing kidney damage to always actively inform their doctors about this situation, especially if they are about to take new medicines.
Sources
- 1st High Pressure League. high blood pressure in numbers (accessed on April 3, 2023)
- 2. Lewis III, J.L. Volumenmangel. MSD Manual. (accessed on April 3, 2023)
- 3. Naughton, C.A. (2008). Drug-Induced Nephrotoxicity. American Family Physician.
- 4. MedLexi.de Kidney damage from drugs. (accessed on April 3, 2023)
- 5. Gesundheitsinformation.de. NSAIDs. (accessed on April 3, 2023)
- 6. Bonmann, T. (2021). Nonsteroidal anti-inflammatory drugs (NSAIDs) and kidney. dialysis current.
- 7. Nelson, D.A., Marks, E.S., Deuster, P.A. (2019). Association of Nonsteroidal Anti-inflammatory Drug Prescriptions With Kidney Disease Among Active Young and Middle-aged Adults. Nephrology.
- 7. Clifford, K.M., Selby A.R., Reveles, K.R. et al. (2022). The Risk and Clinical Implications of Antibiotic-Associated Acute Kidney Injury: A Review of the Clinical Data for Agents with Signals from the Food and Drug Administration’s Adverse Event Reporting System (FAERS) Database. antibiotics.
- 8. Khalili, H., Bairami, S., Kargar, M. (2013). Antibiotics induced acute kidney injury: incidence, risk factors, onset time and outcome. Iranian Medical Act.
- 9. Yellow List. pharmaceutical index. Omeprazole. (accessed on April 3, 2023)
- 10. Yellow List. pharmaceutical index. Lansoprazole. (accessed on April 3, 2023)
- 11. Lazarus, B., Chen, Y., Wilson, F.P. et al. (2016). Proton Pump Inhibitor Use and the Risk of Chronic Kidney Disease. JAMA Network.
- 12. Hentschel, H., Antwerpes, F., Bachinger, F. et al. proton pump inhibitors. DocCheck Flexicon. (accessed on April 3, 2023)
- 13. Watanabe, H., Martini A.G., Brown, E.A. et al. (2021). Inhibition of the renin-angiotensin system causes concentric hypertrophy of renal arterioles in mice and humans. JCI Insight.
- 14. UVA Health. Blood Pressure Drugs May Cause Kidney Damage, Study Suggests. (accessed on April 3, 2023)
- 15. Gabardi, S., Munz, K., Ulbricht, C. (2007). A Review of Dietary Supplement–Induced Renal Dysfunction. CJASN.