Painkillers and your Kidneys

Kidneys are bean-shaped organs in vertebrates that helps to remove excess organic molecules from the blood. They serve the body as natural blood filter and remove water-soluble wastes which are diverted to the bladder.
Painkillers, also known as Analgesics, are medicines that help to control pain, reduce fever and, some also decrease inflammation. Examples are paracetamol, aspirin, ibuprofen, Diclofenac, Naproxen, Aceclofenac, Ketoprofen etc.
Some painkillers contain a combination of painkilling ingredients in one pill, such as Aspirin, Paracetamol and Caffeine or Paracetamol, Ibuprofen and Caffeine.
Many painkillers should not be used if there is decreased kidney function, because they reduce blood flow to the kidney, while long term use with higher doses may harm normal kidney. It is important to know that this medicines are not completely without risk, while helpful, they should be used carefully. Aspirin may increase the tendency to bleed in people with kidney disease, but regular use of low dose aspirin ,75mg is recommended for prevention of heart attack.
The use of painkillers has been associated with 2 different forms of kidney damage- acute renal failure and a type of chronic kidney disease called analgesic nephropathy.
Serum Creatinine Level test can be done to check for kidney damage as it measures the amount of a waste product in your blood that is normally removed by your kidneys. If your kidneys are not working as well as they should, the creatinine level will be increased in your  blood. A urine test for the presence of protein may also be done. Persistent protein in the urine may be an early indication of kidney damage.
To keep your kidney healthy:
1. Avoid self medication.
2. Do not use over-the-counter (OTC) painkillers (e.g. Paracetamol, Ibuprofen etc) more than 10 days for pain or more than 3 days for fever.
3. Avoid prolonged use of painkillers that contain a mixture of painkilling ingredients like Ibuprofen, Paracetamol and Caffeine in one pill. 4. Avoid taking alcohol.
5. Use painkillers exactly as prescribed or as on the label.
6. Use painkillers at the shortest possible dose for a short period of time.
7. If you are taking painkillers, increase the amount of fluid you drink per day to flush out toxins.
8. Make sure you read the warning label before using any OTC painkillers.
9. If you have any kidney disease, consult your doctor before taking any painkiller, particularly NSAIDs (specific group of painkillers). Paracetamol remains the drug of choice for occasional use in patients with kidney disease. Kidney patients who need to use paracetamol habitually should be supervised and be sure to avoid drinking alcohol. NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage.
See your doctor if you have pain or fever for a longer time. The doctor  can check for possible medical problems and advise you about what medication you should take.
If you have been taking painkillers regularly to control chronic pain, you may be advised to find new ways to treat your pain such as behaviour modification or relaxation techniques. Depending on how much your kidney function has declined, you may be advised to change diet, limit the fluid you drink or take medications to avoid Anaemia and bone problems caused by kidney disease.
Kidney disease related to painkillers are preventable. Be mindful of your kidneys.