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Can NSAIDs for Pain Harm Your Kidneys?

A study of US Army soldiers found that those who took high doses of NSAIDs for pain were at a small but significant increased risk of kidney damage.

Have you taken nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac, ibuprofen or naproxen? A study of soldiers showed that people taking high doses of NSAIDs for pain may develop kidney problems (Nelson et al, JAMA Network Open, Feb. 15, 2019).

Studying NSAIDs for Pain Relief:

Previous studies have shown that using NSAIDs for pain can increase biomarkers of kidney damage. Some of those studies focused on older adults, who are at higher risk. However, at least one meta-analysis also found problems among younger people.

The JAMA Network Open study used de-identified medical records of more than 750,000 active duty US Army soldiers. Consequently, these were active young and middle-aged adults. The study included records from 2011 through 2014. During that time, nearly 18 percent of these soldiers got a prescription for one to 7 doses of an NSAID pain reliever in a month. Another 16 percent were prescribed more than 7 doses in a month.

Consequences of Taking NSAIDs for Pain:

Fewer than 1 percent of these people were subsequently diagnosed with acute or chronic kidney disease. Nevertheless, the rate of kidney trouble was about 20 percent higher among people who had received high-dose NSAIDs than among those who had taken none. The absolute risk of acute kidney injury was 3 in 1,000. Additionally, the absolute risk of chronic kidney disease was only slightly lower, at 2 in 1,000. These healthy, active young people should have little likelihood of kidney disease. The authors describe this increased risk as modest but statistically significant.

They state:

“In this study we identified modest but statistically significant associations between the highest level of dispensed NSAIDs and incident AKI and CKD in a large military population. Specifically, the adjusted hazard of each outcome was approximately 20% higher among participants who received more than 7 total NSAID DDDs per month compared with those who did not receive prescription NSAIDs.”

Readers aware of this link are anxious to find alternatives to NSAIDs to ease pain.

Can You Ease Joint Pain with Natural Alternatives?

Q. I had a close relative who self-medicated his joint pain with naproxen for many years. Eventually, that ruined his kidneys and he ended up on dialysis.

I do not want to take that risk. What natural remedies can help ease arthritis now that I am suffering from both knee and hip pain?

A. Besides several home remedies such as Certo and grape juice, gin-soaked raisins and Knox Gelatin, there are many herbs and dietary supplements that can relieve inflammation. They include turmeric or its active compound curcumin, ginger, Boswellia, ashwagandha, MSM and SAMe. You can learn more about these options in either our eGuide to Alternatives for Arthritis (an online resource) or our 104-page booklet, The Graedons’ Guide to Alternatives for Arthritis.

A Word of Caution:

Scientists have devoted less attention to studying botanicals such as turmeric than to pharmaceuticals. While turmeric does not appear to be associated with kidney injury, in rare cases it can damage the liver (LiverTox, May 11, 2021). We urge readers to check with their physician or pharmacist regarding possible herb-drug interactions. Turmeric, for example, appears to interact with oral anticoagulants, especially warfarin, to increase the risk for bleeding. In addition, people can develop allergies to supplements just as they do to drugs.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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