An analgesic is any medicine intended to alleviate pain. Over-the-counter analgesics include the following:
Some conditions make taking these common painkillers dangerous for the kidneys. Taking one, or a combination of, these drugs regularly over a long period of time may increase the risk of kidney problems.
Analgesic nephropathy is a chronic kidney disease that gradually leads to end-stage renal disease and the need for permanent dialysis or a kidney transplant to restore renal function. It can result from taking painkillers every day for several years. And, the painkillers that combine two or more analgesics (for example, aspirin and acetaminophen together) with caffeine or codeine are the most likely to damage the kidneys. These mixtures are often sold as powders. Analgesic nephropathy occurs in four out of 100,000 people, usually in women over 30 years of age.
The following are the most common symptoms of analgesic nephropathy. However, each individual may experience symptoms differently. Symptoms may include:
fatigue or weakness
blood in the urine
an increase in urination frequency or urgency
pain in the back or flank area (where the kidneys are located)
a decrease in urine output
decreased alertness such as drowsiness, confusion/delirium, or lethargy
decreased sensation or numbness, especially in the extremities
easy bruising or bleeding
Some patients experience no symptoms. The symptoms of analgesic nephropathy may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for analgesic nephropathy may include the following:
blood pressure measurement
urine toxicology screen
urinalysis - laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
complete blood count (CBC) - a measurement of size, number, and maturity of the different blood cells in a specific volume of blood.
examination of any tissue passed in the urine
intravenous pyelogram (IVP) - a series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein - to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
Specific treatment for analgesic nephropathy will be determined by your physician based on:
your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference
Treatment may include:
discontinuation of all suspect analgesics, especially over-the-counter (OTC) medications
behavioral modification or counseling as an alternative method of chronic pain control
Treatment focuses on preventing any further kidney damage, and treatment of any existing kidney failure.
Some reports have attributed incidents of acute kidney failure to the use of painkillers, including aspirin, ibuprofen, and naproxen. Many of the patients in these reports had risk factors such as the following:
systemic lupus erythematosus (lupus)
chronic renal conditions
a recent binge of alcohol consumption
Consult your physician for more information about diagnosis and treatment of analgesic nephropathy and acute kidney failure.
© 2013 Main Line Health