Analgesic Nephropathy

Analgesic Nephropathy is kidney failure that results from taking large amounts of over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, acetaminophen, ibuprofen, ketoprofen and naproxen sodium, for a prolonged periods of time. Analgesic nephropathy usually results from people self-medicating, perhaps to relieve chronic pain from arthritis or back pain. About three to five percent of the new cases of chronic kidney failure each year may be caused by chronic overuse of these medicines.

What are the symptoms of Analgesic Nephropathy?

The following are the most common symptoms of Analgesic Nephropathy. Some patients experience no symptoms. Other individuals will have some, but not necessarily all, of the following symptoms:

  • Fatigue
  • Blood in the urine (Hematuria)
  • Increased urination frequency or urgency
  • Decrease in amount of urine or difficulty urinating
  • Back or side pain (where the kidneys are located)
  • Drowsiness, confusion/delirium, or lethargy
  • Numbness, especially in the fingers and toes
  • Nausea, vomiting
  • Fluid retention (Edema), especially in the lower legs
  • Easy bruising or bleeding

Symptoms of Analgesic Nephropathy may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is Analgesic Nephropathy diagnosed?

Your doctor can check your kidneys by measuring the amount of waste products in your blood that are normally removed by your kidneys through simple blood tests like BUN (blood urea nitrogen) and serum creatinine level. A urine test may also be performed to measure the amount of protein in your urine. Regular protein in the urine may be an early indicator of kidney damage. Your blood creatinine is used to estimate your Glomerular Filtration Rate (GFR). The GFR measures the kidneys' ability to filter and remove waste.

How is Analgesic Nephropathy treated?

Your doctor will determine the treatment of Analgesic Nephropathy based on factors such as your overall health and medical history, the severity of the disease and your tolerance for certain medications or procedures.

Treatment may include:

  • Discontinuing all analgesics believed to be causing the disease, especially over-the-counter (OTC) medications
  • Changes in your diet
  • Medication
  • Steps for changing your pain management behaviors or counseling as an alternative method of chronic pain control

Your treatment will focus on preventing continued kidney damage, and treating any existing kidney injury.

How is Analgesic Nephropathy prevented?

Doctors usually recommend patients with kidney disease use acetaminophen because of the possible bleeding complications that may occur when these patients use aspirin. However, their doctors should supervise kidney patients who need to use acetaminophen habitually. Consult your doctor for the best choice for you.

  • Limit use of over-the-counter (OTC) pain relievers. If you have prolonged pain or fever, see your doctor
  • Avoid using of analgesics that contain a mixture of painkilling ingredients (like aspirin, acetaminophen and caffeine) for extended periods of time
  • If you are taking analgesics, increase your fluid levels to six to eight glasses a day
  • If you already have kidney disease, talk to your doctor about the best analgesic options for you
  • If you have heart disease, high blood pressure, kidney disease or liver disease or if you take diuretic medications or are over 65 years of age, use NSAIDs (nonsteroidal anti-inflammatory drug) under the supervision of your physician
  • Make sure your doctor knows all medicines you are taking, even over-the-counter medicines
  • Read the warning label before using any over-the-counter analgesics