Most of us have taken painkillers at some point — for headaches, back pain, joint pains, or even after a fever. They’re easy to get, often available over the counter, and seem harmless when taken occasionally. But did you know that some painkillers, especially a group called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), can harm your kidneys if used wrongly?
Let’s understand how.
A Real-Life Scenario
Mr. Kumar, a 58-year-old gentleman with high blood pressure, developed knee pain. To get quick relief, he started taking ibuprofen daily for about a week. Soon, he noticed decreased urine output, swelling in his legs, and fatigue. On visiting the hospital, tests revealed that his kidneys were not working properly — a condition called NSAID-induced Acute Kidney Injury (AKI).
Thankfully, after stopping the painkiller and receiving proper medical care, his kidney function improved. But not everyone is this lucky.
Which Painkillers Can Harm the Kidneys?
The common NSAIDs that can cause kidney damage include:
• Ibuprofen
• Diclofenac
• Naproxen
• Indomethacin
• Ketorolac
• Etoricoxib and other COX-2 inhibitors
These drugs reduce pain and inflammation but also reduce blood flow to the kidneys, making them vulnerable.
How Do NSAIDs Affect the Kidneys?
• Dose-dependent effect: The higher the dose and the longer you take it, the greater the risk of kidney damage.
• Idiosyncratic reaction: Rarely, even a small dose can cause sudden kidney injury in certain individuals, without warning.
Other Kidney Problems Caused by Painkillers
Apart from acute kidney injury, long-term use of painkillers can cause:
• Chronic kidney disease (slow, permanent damage over years)
• Papillary necrosis (damage to kidney tissue due to poor blood supply)
• Electrolyte imbalances like high potassium or low sodium
Safer Options
Not all painkillers are equally harmful.
• Paracetamol (Acetaminophen): Usually safer for the kidneys when used in the correct dose.
• Topical pain relievers (ointments, gels, sprays): Can sometimes help without affecting the kidneys.
• If stronger painkillers are required, your doctor may prescribe opioids (like tramadol) in select cases under strict supervision.
Treatment of NSAID-Induced Kidney Injury
• The first step is to stop the NSAID immediately.
• Supportive care with fluids and monitoring is often required. In selected cases short course steroids can be given as per the doctors advice.
• In severe cases, dialysis may be needed temporarily until the kidneys recover.
If You Must Use NSAIDs
• Use the lowest possible dose.
• Take them for the shortest period of time.
• Avoid combining different NSAIDs.
• Never take them daily without medical advice.
• People with diabetes, high BP, heart disease, or pre-existing kidney disease should be extra cautious.
Long-Term Impact of Painkillers
Regular, unsupervised use of NSAIDs can lead to:
• Permanent kidney damage
• Requirement for dialysis
• Higher risk of heart attacks and stomach ulcers
Key Takeaways
• Painkillers can be helpful, but not all are safe for your kidneys.
• Paracetamol is generally safer than NSAIDs, but even that should not be overused.
• Always consult a doctor before taking painkillers regularly.
• Protecting your kidneys today means avoiding dialysis and transplant tomorrow.
Bottom line: Painkillers are friends when used wisely, but they can become dangerous enemies if overused. Always respect your kidneys — they work 24/7 to keep you healthy, and they deserve your care!