Can NSAIDs for Pain Harm Your Kidneys?

Have you taken nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac, ibuprofen or naproxen? A recent study shows 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 new 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:

“These potentially preventable cases are of particular concern in a population in which medical readiness is a foundation of national security. Because most participants were younger than 35 years and free of hypertension, diabetes, and/or rhabdomyolysis, this study provided an unusual opportunity to evaluate young, healthy, active adults who received relatively high NSAID doses (mean, 1.6 DDDs per prescription). No significant elevation in risk was observed among soldiers prescribed between 1 and 7 DDDs of NSAIDs per month.”