Linking Pain Meds to Kidney Damage
Times Union
November 2, 2015
* * * USED WITH PERMISSION * * *
If you're already taking a drug called an ACE inhibitor and a diuretic for high blood pressure, adding ibuprofen could set you up for kidney damage.
Kidney specialists call that combination of drugs "the triple whammy." No kidding: that's the term in the medical literature.
In fact, long-term, regular use of ibuprofen and other nonsteroidal anti-inflammatory drugs, called NSAIDs (pronounced "ehn-sedz"), carries a risk of disrupting blood flow to the kidneys, even when not combined with those other medications, according to Amy Barton Pai, a researcher at Albany College of Pharmacy and Health Sciences. Other examples of NSAIDs include naproxen (Aleve) and numerous prescription drugs, including Celebrex and Lodine.
Unfortunately, patients taking NSAIDs don't always know the risk. Doctors don't always ask the right questions before recommending NSAIDs. And pharmacists don't consistently advise customers about NSAID overuse, according to Barton Pai.
Barton Pai and her colleagues have more than $200,000 from the U.S. Food and Drug Administration to take a step toward changing that.
The researchers will analyze a national database to determine the link between the use of prescription NSAIDs and acute kidney injury. Then they will work with CapitalCare Medical Group family practices in Niskayuna, Guilderland and Schenectady, as well as pharmacies near those offices, to develop an education program aimed at getting out the message about NSAID risks.
The work is long overdue, said BetsyBelle Eadie, a 70-year-old North Greenbush resident whose kidney problems "kicked into gear a lot faster and a lot harder" after she was prescribed a prescription NSAID for arthritis. That was 20 years ago, before much was known about anti-inflammatory drugs' effects on the kidneys.
Even today, perhaps 10 percent of patients that Albany kidney specialist Dr. Thomas Schumacher sees in the hospital for acute kidney injury are there due to NSAID use, he said. Typically, they didn't know they had other risk factors for kidney disease when they took nonsteroidals.
"You can get into trouble with a single dose, if you're a high-risk patient," Barton Pai said.
However, labels on NSAIDs sometimes do little to warn the patient of risks associated with kidney damage, emphasizing the possibility of stomach bleeding instead, she said. And although kidney specialists are aware of the dangers they pose, many primary care doctors do not screen patients for early signs of kidney disease before prescribing NSAIDs.
Most doctors are aware of the potential side effects of NSAIDs, said Louis Snitkoff, chief medical officer at CapitalCare. The challenge is that patients equate easy access to the medications with safety.
"A study like this will probably just help raise awareness among patients and providers, so maybe you think twice," Snitkoff said.