Most prescription drugs are eliminated by the kidneys. The same is true of many over-the-counter medications. Even if you do not have any degree of kidney failure, it is important to talk to your doctor and pharmacist about the medicines you take, what you drink, and how often you take them. It is necessary to adjust the dose to avoid adverse or toxic effects, or to avoid aggravating kidney damage.
Steven Coca, associate professor of medicine and nephrology at the Icahn School of Medicine at Mount Sinai in New York, says that you need to know the estimated glomerular filtration rate (eGFR), which is the main parameter of kidney function, and the albumin ratio. urine creatinine (UACR), which indicates kidney damage. eGFR is included in all standard blood tests that are usually covered by insurance. It belongs to the most basic analysis that can be prescribed.
The urine albumin/creatine ratio UACR test, which is also usually or partially covered, indicates protein in the urine by insurance; It is usually done once a year to monitor the state of the kidneys in a person with kidney disease. This test also monitors the kidneys in patients who have type 1 diabetes for five years or more and in patients with type 2 diabetes.
“You need to know those numbers because chronic kidney disease is one of the main risk factors for cardiovascular disease. Many medications that older people take are eliminated by the kidneys and in some cases can worsen kidney damage or pre-existing kidney disease,” says Coca.
People vulnerable to the adverse side effects of any drug in kidney patients are adults over 65 years of age, those with kidney disease, dehydrated people, patients with low blood pressure and suffering from several simultaneous diseases (comorbidities). such as diabetes or heart disease, or having had heart surgery or a heart transplant, explains Karthik Ramani, a nephrologist at Michigan Medicine at the University of Michigan.
Ramani suggests consulting with a qualified health care provider or pharmacist before taking medications, including medications and herbal supplements, and also doing your research for information from verified sources, such as the National Kidney Foundation (NKF). ), American Medical Association (AMA), National Institutes of Health (NIH), American Society of Nephrology (ASN).
“In some situations, such as when a patient needs chemotherapy, which can save his life but at the same time damage his kidneys, the patient can take chemotherapy drugs, even though kidney damage is possible. This type of thing should be discussed with a doctor to evaluate the benefits and risks of taking drugs,” said Dr. Michelle Josephson, a nephrologist and professor of medicine and surgery in the Department of Medicine at the University of Chicago and chair of the American Society of Nephrology.
Derek Owen, a clinical pharmacist on the kidney team at the University of Chicago Department of Medicine, cautions against taking the drug because it is safe because it can be obtained without a prescription. “Many over-the-counter products contain many ingredients, so it’s important to always read the label to make sure all the ingredients are safe for you,” he says.
These are some drugs that can affect the kidney.
1. Common pain relievers
What are they? Most over-the-counter pain relievers fall into two categories, nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. NSAIDs relieve pain, reduce fever, and relieve cold symptoms. These are often more effective at reducing inflammation than acetaminophen, which is used to relieve pain and reduce fever.
Examples: Over-the-counter NSAIDs include aspirin (Bayer, Anacin, Bufferin), naproxen (Aleve), and ibuprofen (Advil, Motrin). Prescription NSAIDs are used to treat arthritis pain, gout, menstrual cramps, and headaches. Acetaminophen includes brand names such as Tylenol and Actamin.
Common prescription pain relievers include codeine, oxycodone, hydrocodone, and methadone. Owen adds that typical NSAIDs include indomethacin, meloxicam and celecoxib.