If you have chronic kidney disease (CKD), diabetes, or high blood pressure—or if you take certain blood pressure medicines that affect your kidneys—you should take steps to protect your kidneys from harm.
ACE inhibitors and ARBs are two types of blood pressure medicine that may slow the loss of kidney function and delay kidney failure. You can tell if you’re taking one of these medicines by its generic name. ACE inhibitors end in –pril and ARBs have generic names that end in –sartan; for example, lisinopril and losartan.
The next time you pick up a prescription or buy an OTC medicine or supplement, ask your pharmacist how the product may affect your kidneys or react with other medicines you take.
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Fill your prescriptions at only one pharmacy or pharmacy chain so your pharmacist can monitor your medicines and supplements, and check for harmful interactions between your medicines.
Keep an up-to-date list of your medicines and supplements in your wallet. Take your list with you, or bring all your medicine bottles, to all health care visits.
If you take OTC or prescription medicines for headaches, pain, fever, or colds, you may be taking a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs include popular pain relievers and cold medicines that can damage your kidneys if you take them for a long time, or lead to acute kidney injury if you take them when you are dehydrated or your blood pressure is low.
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Ibuprofen and naproxen are NSAIDs. NSAIDs are sold under many different brand names, so ask your pharmacist or health care provider if the medicines you take are safe to use.
Almost everyone gets sick once in a while. Your doctor or pharmacist can help you plan ahead to keep your kidneys safe until you get well. Prepare in advance so you know what to do if you have pain or a fever, diarrhea, nausea, or vomiting, which can lead to dehydration.
In normal, everyday circumstances, taking your blood pressure medicines as prescribed helps protect your kidneys. However, certain situations, such as when you’re dehydrated from the flu or diarrhea, can lower the blood flow to your kidneys and cause harm.
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When you get sick from something like the flu or diarrhea, or have trouble drinking enough fluids, the blood pressure in your body may decrease. As a result, the pressure in your kidneys can be low, too.
In most cases, healthy kidneys can protect themselves. However, if you keep taking your blood pressure medicines when you’re dehydrated or have low blood pressure, your kidneys might have a hard time protecting themselves. The pressure within your kidneys might drop so low that your kidneys won’t filter normally.
If you’re dehydrated, NSAIDs can also keep your kidneys from protecting themselves. As a result, taking NSAIDs when you’re sick and dehydrated can cause kidney injury.
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Read about what else you can do to keep your kidneys healthy. If you already have CKD, the steps you take to protect your kidneys also may help prevent heart disease—and improve your health overall.
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Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (), part of the National Institutes of Health. translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by is carefully reviewed by scientists and other experts.
The would like to thank Jeffrey Fink, MD, MS, Chief, Division of General Internal Medicine, University of Maryland School of MedicineWhat do you do if you have a headache, fever, or muscle pain? Chances are you go to the local drug store to pick up an over–the–counter (nonprescription) pain medicine. These drugs are the medicines most often used by Americans. Pain medicines, also called analgesics, help relieve pain, fever, and even inflammation. These medicines may help with arthritis, colds, headache (including migraine), muscle aches, menstrual cramps, sinusitis and toothache.
These drugs are effective and usually safe. However, it is important to realize that no medicine is completely without risk. They should be used carefully. When used improperly, pain medicines can cause problems in the body, including the s. According to the National Foundation, as many as 3 percent to 5 percent of new cases of chronic failure each year may be caused by the overuse of these painkillers. Once disease occurs, continued use of the problem drug makes it worse.
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Nonprescription pain medicines should not be used without your doctor’s permission if you know you have low function. Also, even if your function is good, long–term use with high doses of these pain drugs may harm the s. damage happens because high doses of the drugs have a harmful effect on tissue and structures. These drugs can also reduce the blood flow to the . If you are older, your s may have a stronger reaction to these medicines and you may need a smaller dose.
Disease from pain medicines is often preventable. You can change your risk by how you take medicines. To avoid problems, it is important to follow the instructions on the label. You should tell your health care team how often you use these drugs and how many of pills you take. You should drink plenty of fluids and avoid becoming dehydrated when you use these medicines. If you have special risks, your doctor may be able to recommend a safer alternative and can order regular tests to monitor function.
Analgesics are medicines that help to control pain and reduce fever, and some types also decrease inflammation. These are commonly used analgesics:
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Although aspirin was most common analgesic for decades, today, the most commonly used over–the–counter pain medicine is acetaminophen. This drug is available under the brand name Tylenol® and as a generic (no brand name) with the word “acetaminophen” on the package. It is often effective for mild to moderate pain. Its safety depends on how it is used. People who take too much or take it too often risk side effects or worse. Acetaminophen is also found in combination with other ingredients in many cold, sinus, and cough medications. If you take these drugs together, the dose can add up.
Aspirin. This is one of the drugs grouped together under the name “nonsteroidal anti–inflammatory drugs” or NSAIDs. Nonsteroidal anti–inflammatory drugs (NSAIDs) are a specific group of pain relievers. Some NSAIDs are available over the counter. This includes different brands of aspirin, ibuprofen, naproxen sodium and ketoprofen. Prescription strength NSAIDs are also available.
Acetaminophen is the drug often recommended for occasional use in patients with disease. But everyone with disease should rely on their doctor or other health care professional for a personal recommendation. It is important to know that any drug can be harmful if used at high doses or very frequently. People with disease should also be sure to avoid drinking alcohol while taking pain medicines.
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NSAIDs are usually safe for occasional use when taken as directed. However, if your doctor has told you that you have low function, NSAIDs might not be right for you. These medications should only be used under a doctor's care by patients with disease. Also, they might not be the best choice for people with heart disease, high blood pressure or liver disease. Some of these drugs affect blood pressure control. High doses over a long period of time can also lead to chronic disease and even progress to failure.
For people without disease, the recommended dose of aspirin can be safe if you read the label and follow the directions. When taken as directed, regular use of aspirin does not seem to increase the risk of disease in people who have normal function. However, taking doses that are too large (usually more than six or eight tablets a day) may temporarily and possibly permanently reduce function. In people with disease, aspirin may increase the tendency to bleed.
My doctor recommended that I take an aspirin in low doses every day to prevent heart attacks. Will this hurt my s?
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It’s not likely. There is no evidence of risk regarding the regular use of aspirin in the small doses recommended for prevention of heart attacks. Use of a “baby aspirin” is fine, even with reduced function.
You should speak to your doctor about the best choice for you. In addition, if you have a medical condition, you should only use NSAIDs under your doctor's supervision.
Your doctor can check your s by doing a simple blood test
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