Nsaids: Why are nsaids bad for kidney... - Kidney Disease

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Tilantoe profile image
32 Replies

Why are nsaids bad for kidney problems?

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Tilantoe profile image
Tilantoe
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32 Replies

NSAIDs are reportedly an at-risk factor for people over 60 with CKD. There have been studies completed that show that many people still take them even with knowledge of their having Chronic Kidney Disease. Sometimes, you don't have an option not to. I take a daily 81mg dose of aspirin for a cardiac issue. It's helped me even though NSAIDs, in general, are not recommended for me. The choice is to take the aspirin and help my heart and possibly damage my kidneys or not take them and have my heart have a more immediate impact on my health than my kidney disease. Sometimes a choice has to be made. After talking to my cardiologist, nephrologist, and primary care physician, I made the decision to continue with the aspirin regimen. Also, there have been studies that show that the benefits of an aspirin regimen are not as beneficial as once thought. Hence, my decision after consulting with the doctors most knowledgeable about my health concerns. My life, my health, my choice.

There is a fairly good article on point from the CDC, Center for Disease Control that may help you with this question. I've included a link below.

cdc.gov/diabetes/news/pdf/n...

Tilantoe profile image
Tilantoe in reply to

Thankyou that's very helpful

LorrieC profile image
LorrieC in reply to

I was given the OK to continue with Meloxicam at Stage 3a CKD. I tried to stop it for a week, but I couldn't walk due to feet problems. I am thinking of lowering the dose of 15 mg to 7.5 mg.

in reply toLorrieC

When you have questions about medications I recommend you look up the med on drugs.com I've included the link for meloxicam below for you. This could be one of those times where you need to speak to your doctors before you switch dosages. Perhaps there is a better medicine on the market now or a better dosage. Once you read the information in that link, you'll better be able to formulate questions for your doctor. Don't limit the questions to the doctor who ordered the original script. Check with all of the doctors who are on your Care Team and then you should be able to make the decision right for you.

drugs.com/meloxicam.html

LorrieC profile image
LorrieC in reply to

Thank you for the link. I will check it out.

nascar4433 profile image
nascar4433 in reply toLorrieC

I had been taking Meloxicam for about 8 months but my new nephrologist made me stop it immediately. I had a really hard 6 wks after and could barely get out of bed. Was given 40mg Prednisone last week and I actually can move again. Side note: My numbers haven't changed being off of it for 3mo, but I figure my nephrologist knows better than I about long-term damage from the Meloxicam. Good luck.

LorrieC profile image
LorrieC in reply tonascar4433

Primary care physicians don't have a clue. At my first visit with the nephrologist, he made me stop taking meloxicam cold turkey. I was the same as you regarding pain and I am still in pain. The problem with steroids is the pain returns when you stop taking them. Plus, it raises the risk of developing Type 2 Diabetes. I'm sticking with Tylenol which does very little for chronic pain

nascar4433 profile image
nascar4433 in reply toLorrieC

Thanks for the reply. I've been taking oxycodone for years and my pain mgmt specialist added the Meloxicam. It helped and I could take less oxy. Actually, my Primary was good about watching labs and deciding I needed a nephrologist for real. I was supplementing with Tylenol as well, but of course it has it's kidney issues. It's a balancing act...take not-so-good drugs be somewhat mobile, or stop them and be in too much pain to function like a human being. I have full confidence in my new nephrologist, so we'll see. Good luck...I hope you find a way to safely decrease your pain. I went to p/t for 15 mo., then took a break in June, but started back this week. It has helped my mobility. You may want to check it out. Blessings.

BIGTWINKIE profile image
BIGTWINKIE in reply toLorrieC

My husband was on meloxicam for 20 years. His primary did bloodwork annually. He developed a blood clot last fall which required testing and treatment. His heart doctor finally picked up on his kidney disease in a pre-procedure blood panel. This was after two lengthy contrast-dye procedures. Someone noticed his kidney numbers and put a halt to the next test they wanted to run. Anyway, back to his primary doctor, to see what the hell?He reviewed the blood work from the last few years and, surprise, his kidney function had been declining every year for the last three years! He had just missed it! He took him off the meloxicam and told him to take Tylenol xtra as needed for pain. (that is another story). My husband started taking Relief Factor for pain not really expecting much. It has been four months, and it has helped A LOT. Of course we have changed diet, lost weight, etc. I’m sure less weight on those knees and feet helps too. It doesn’t work for everybody, but it has been pretty amazing for him. Good luck to you.

Samaka profile image
Samaka in reply to

we can take warfarin instead of asprin ? warfarin do not harm kidneys

in reply toSamaka

I'm not sure who you mean by "we" but, Warfarin is to be avoided for people over sixty-five, have kidney disease and a variety of other issues. If you'd like to read about those restrictions check out this link.

drugs.com/warfarin.html

Samaka profile image
Samaka in reply to

we i mean chronic kidney disease patients

in reply toSamaka

Then as you read in the link I provided, it is recommended that folks with CKD should not take Warfarin. If your doctors believe that that is the only option for you then it's up to you to make the decision. Best of luck.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply toSamaka

If you ARE taking warfarin so not stop just because of this article. It lists all sorts of issues with many different diseases like diabetes and liver disease but does not say why. Warfarin and/or coumadin is a life saver and needs to be taken under a doctors close supervision. It is not a replacement for aspirin. ALWAYS consult with your doctor about starting or stopping any medication.

lowraind profile image
lowraind in reply to

Hi,

I have continued with the low dose aspirin, once a day, and my gfr is still improving. Slowly, but surely.

lowraind

in reply tolowraind

Good for you! I know that for me it was initially a tough choice...risk a serious heart issue or a drop in my GFR. After more research and consultations it turned out to be an easier decision. A protected heart.

Was it a difficult decision for you?

lowraind profile image
lowraind in reply to

Not really. I asked the nephrologist about it and was told it was not a problem. Perhaps if I did not see the improvements, I would have tried not taking it.

newbie1956 profile image
newbie1956 in reply to

Mr Kidney, I hope fish oil is good for heart and ok for stage 3 CKD. ;) Better than aspirin.

in reply tonewbie1956

My cardiologist was the doctor who suggested I begin the aspirin regimen almost 20 years ago. The choice was aspirin to help my heart or a bad heart getting worse. To me, it was a no-brainer. I've only known about having CKD for 17 months and at that time my GFR has gone from a low of 32 to its current 65. THE ASPIRIN DID NOT CAUSE MY GFR TO INCREASE. That is attributable not to the aspirin, but to dietary changes, exercise, and adjustments to all other medications.

I'm certainly not advocating everyone take aspirin. For me, the choice was an easy one way back when I started it. When I found out I had CKD, my first question was what caused it. My nephrologist was the one who told me it was the lifetime of high blood pressure and 16 years of Type 2 Diabetes. Another appointment with my cardiologist, specifically about the aspirin, and my research, said it was a choice I would have to make. A bad heart getting worse or bad kidneys. For me, in my situation, and with the approval of every doctor on my Care Team, I continue with the aspirin regimen.

newbie1956 profile image
newbie1956 in reply to

Sounds great, Sir.

I'll ask my doctor about aspirin vs fish oil next appointment. Who knows, I may need both. As it is, the only thing I take is 5MG amlodipine (Norvasc) for b/p.

And keep reminding us about EXERCISE... Thank you.

in reply tonewbie1956

After an ER visit due to a reaction to lisinopril, I was switched to 10 mg of Amlodipine and it has been great for me ever since. Before I forget, I didn't mention anything about fish oil in my post because I'm not familiar with its claims and I don't know anyone who was taking it so I didn't feel comfortable in speaking on its benefits. Be sure the doctors you speak to about the aspirin regimen are your cardiologist, nephrologist, and primary care physician. Once they weighed in and I made my decision I informed the rest of the doctors/professionals on my Care Team. An aspirin regimen may not be recommended for everyone with or without the complicating factor of CKD, but in my case, it was strongly suggested and it has worked. One final point. I monitor my bp every morning and I have an EKG twice a year and with any severe issue, I'm making an appointment with my cardiologist. The aspirin regimen may not last forever, but then I won't either, but for now, it's working.

newbie1956 profile image
newbie1956 in reply to

Omega-3 fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Omega-3 fatty acids are essential nutrients that are important in preventing and managing heart disease. Findings show omega-3 fatty acids may help to: Lower blood pressure. (my husband is 82 & has no health issues but has been taking fish oils for 15 years or more. Doctors tell him to keep doing what he's doing)

in reply tonewbie1956

Your husbands' sentiment regarding doing what's working is the same as mine for the aspirin. I have marked it down should the cardiologist or nephrologist tell me to stop the aspirin regimen. At least now I'll have a Plan B if they tell me to stop.

Northfields profile image
Northfields in reply tonewbie1956

My nephrologist advised against fish oil supplments because unlike medicines such as aspirin, they're not regulated. That means the manufacturer doesn't have to prove that the contents correspond to the label, so often the actual omega 3 level is much lower than stated. So my nephrologist advised eating fatty fish low in mercury e.g. wild salmon or sardines, twice a week instead.

newbie1956 profile image
newbie1956 in reply toNorthfields

I do appreciate that. Thank you

CatOnACloud profile image
CatOnACloud in reply toNorthfields

Theres a prescription fish oil that includes omega 3, 6, and 9s. Going by memory there. I cannot recall the brand name! Starts with an ‘L’, not lipitor. Anyway, my bottle says Omega-3 Acid Ethyl Esters, and i am told to take 4 a day but i can only stomach 2. They were approved by nephrologist. They lower my triglycerides which are high due to my adrenal failure. They help with cholesterol and Ldl/Hdl as well. Ah ha! Lovaza 1gm, at least in the USA…

Ladybug12 profile image
Ladybug12 in reply toCatOnACloud

It's Lovaza, I think

Bassetmommer profile image
BassetmommerNKF Ambassador

"Ibuprofen and other NSAIDs block prostaglandins, natural body chemicals that normally dilate blood vessels leading to the kidneys. Blocking prostaglandins may lead to decreased blood flow to the kidneys, which means a lack of oxygen to keep the kidneys alive. That can cause acute kidney injury "(goodrx.com/blog/nsaids-ibup...

"NSAIDs are usually safe for occasional use when taken as directed, but if you have known decreased kidney function, they should be avoided. These medications should only be used under a doctor's care by patients with kidney disease, heart disease, high blood pressure or liver disease or by people who are over 65 or who take diuretic medications. NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage." kidney.org/atoz/content/pai...

Medications (not just NSAIDS) is the cause of my stage 4 kidney disease. I wish I knew what I know now back then......

Tilantoe profile image
Tilantoe in reply toBassetmommer

Thankyou.

Ladybug12 profile image
Ladybug12

I thought I might relate my personal experience with NSAIDS to expand on answers given.

A few years ago (56yrs old at the time this occurred), and before being diagnosed with kidney disease, I had an appendectomy and was given an IV NSAID (Toradol) for pain afterwards.

I noticed a lot of fluid retention, but was told by my surgeon that it was due to infection (found when appy done) and body would take care of it.

I continued to retain fluid (12 lbs which equals 6 quarts) and eventually ended up with heart failure (probably because quickly gained fluid stressed my heart).

This was my first and only episode of heart failure.

As someone already mentioned, Nonsteroidal anti-inflammatory drugs (NSAIDs) decrease prostaglandin synthesis and may precipitate fluid retention.

Of course, I was given the Toradol IV and the fluid retention happened quickly, but the same thing can happen with oral NSAIDS.

That is also one of the reasons that people with high BP should not take them. Increase in fluid can cause increase in BP.

After this I ended up with Stage 2-3 kidney disease.

(BTW, I did have hypertension at the time, and was on meds to control it. The only heart issue I had was slight mitral valve regurg since young adult).

So, I do question why the Toradol was given to me in the first place.

CatOnACloud profile image
CatOnACloud in reply toLadybug12

Toradol is standard pain mgmt now after surgery…doesn’t do a thing for me pain wise, so I am not a fan! It’s because it’s considered non addicting, as opposed to all the opioids…

Bobbiereed profile image
Bobbiereed

My 22 year old son, a student athlete did take these medications--although it was never really determined what caused his kidneys to fail, leading him to dialysis and transplant, I can't help but believe they contributed to the demise of his kidneys. Please don't take them. A couple weeks ago I was at a Acute Kidney Injury Symposium and a special presentation was done on these medications. The presenter indicated that through a research study done, just four continuous days of taking them can lead to damage of your kidneys.

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