Open up your medicine cabinet and you are likely to find a smattering of pill bottles and at least one type of pain medication. Most people don't realize that more than 66 percent of all prescription medications and a large class of over-the-counter pain medications, non-steroidal anti-inflammatory drugs (NSAIDs), are cleared by the kidneys.
You may be wondering what it means for a medication to be "cleared" by the kidneys. Based on their chemical composition, medications remain active in the body for varying lengths of time. While you may typically think of clearance in terms of the retail sales rack, in the medical context, clearance refers to the rate at which your kidneys remove or filter medications from your blood and your body. Kidneys can either degrade or remove medications from your system. If your kidneys aren't working properly, medications can build up. You and your doctor may need to work together to adjust medication dosing and prevent adverse effects, including further kidney damage.
Common prescription and over-the-counter medications may need to be adjusted or avoided if you have kidney damage. Certain cholesterol medications, beta blockers, anti-fungals, antibiotics, antiviral and pain medications are cleared by the kidneys. Heart medications, blood pressure medications, diabetic medications and insulin are also cleared by the kidneys. If you have decreased kidney function, certain types of pain medications, including NSAIDs, are not recommended because they can reduce blood flow to the kidneys. Narcotic pain medications can build up and cause changes in consciousness for patients with chronic kidney disease.
Medications can be lifesaving and life-improving, but they often come with risks and side effects. Many people don't know how well their kidneys are functioning, so they don't realize that they may need to make modifications to their treatment regimen. In honor of National Kidney Month this March, spread the word about the importance of protecting your kidneys when taking medications.
The National Kidney Foundation offers five factors to consider before you reach into the medicine cabinet:
- Kidney function. How well are your kidneys working? Are they filtering wastes properly? Have they been damaged? Find out with two simple tests: a urine test for albumin, a protein which can indicate kidney damage, and a blood test for serum creatinine to calculate an eGFR measurement. Your eGFR estimates how well your kidneys are filtering wastes from the blood.
Speak with your clinician and pharmacist to evaluate the risks and benefits of taking a particular medication. Ask questions to see if the types of medication you take need to be adjusted based on your kidney function. As always, learn the facts and weigh the pros and cons based on your individual health needs.
Have a question about your protecting your kidneys and taking medications? Ask in the comments below!
For more by Leslie Spry, M.D., FACP, click here.
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