DIFFICULT CHOICE: Avoid Pain or Damage Kidneys?
All non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with the development of acute kidney injury
Heavy or long-term use of some of these medicines, such as ibuprofen, naproxen, and higher dose aspirin, can cause chronic kidney disease known as chronic interstitial nephritis
NSAIDs can cause two different forms of acute kidney injury.
Haemodynamically mediated (eg, pre-renal injury and/or acute tubular necrosis).
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Immune mediated (eg, acute interstitial nephritis).
Acute kidney injury represents a continuum of renal injury ranging from clinically asymptomatic changes in renal function to renal failure and death. Acute kidney injury is characterised by a rapid fall in glomerular filtration rate (GFR) over hours to days
In the general population, the pooled odds ratio (OR) of AKI for current NSAID exposure was 1.73 (95%CI 1.44 to 2.07), with somewhat higher risk observed in older people (OR 2.51, 95%CI 1.52 to 2.68). In people with CKD, individual study OR of AKI due to current NSAID exposure ranged from 1.12 to 5.25, with pooled estimate OR 1.63 (95% CI 1.22 to 2.19)
Zhang, X., Donnan, P.T., Bell, S. et al. Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and meta-analysis. BMC Nephrol 18, 256 (2017)
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