July 28, 2021

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Supplements + OTCs May Hurt Your Kidneys – Health Essentials from Cleveland Clinic

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Unless you’ve had problems in the past, you probably take for granted that your kidneys are working as they should. But 1 in 5 men and 1 in 4 women in the United States are estimated to have chronic kidney disease, and most people who have it don’t know it.

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Even more alarmingly, over-the-counter medicines, common prescriptions and nutritional supplements can have serious effects on kidney function. You are at higher risk if your kidneys aren’t completely healthy to begin with, says nephrologist Robert Heyka, MD.

Only your doctor can perform
the tests to determine whether your kidneys are healthy. However, there are
certain health problems that make a person more likely to develop kidney
disease.

Health
conditions that require kidney screenings

If you have one of these
health conditions, or if you or your family has a history of kidney problems,
it’s important to have your kidneys checked once a year:

But even if you don’t have
any risk factors, a yearly check-up with blood pressure check, lab and urine
tests is the only way to get a clear picture of your kidney function, says Dr.
Heyka.

The
drugs and supplements that should cause concern

The following drugs and
supplements can affect kidney function:

1. NSAIDS
(Non-steroidal anti-inflammatory drugs)

NSAIDs are very effective
medications for multiple medical problems. But taking NSAIDS can affect
the kidneys, and can cause damage, especially if you’re also taking
diuretics (“water pills”) or ACE inhibitors.

NSAIDS include over-the-counter
painkillers like aspirin (Ascriptin®, Bayer® and Ecotrin®), ibuprofen (Advil®
and Motrin®), and naproxen (Aleve®).

They also include
prescription drugs like:

  • Naproxen sodium (Anaprox®).
  • Celecoxib (Celebrex®).
  • Sulindac (Clinoril®).
  • Oxaprozin (Daypro®).
  • Salsalate (Disalcid®).
  • Diflunisal (Dolobid®).
  • Piroxicam (Feldene®).
  • Indomethacin (Indocin®).
  • Etodolac (Lodine®).
  • Meloxicam (Mobic®).
  • Naproxen (Naprosyn®).
  • Nabumetone (Relafen®).
  • Ketorolac tromethamine (Toradol®).
  • Naproxen/esomeprazole (Vimovo®).
  • Diclofenac (Voltaren®).

Using these medications with
caffeine can further harm your kidneys. When taking these medications, be sure
to check regularly with your doctor if you have impaired kidney function.

2. Antibiotics

Certain antibiotics are
removed from the body through the kidneys, so taking them can put extra strain
on your kidneys. Penicillin, cephalosporins and sulfonamides in particular can
be harmful to your kidneys.

Long-term antibiotic use can
injure your kidneys, even if you’re otherwise healthy. And for people whose
kidneys aren’t functioning at 100% to begin with, antibiotics can build up in
the body and cause damage.

Despite this, it’s important
to keep in mind that antibiotics can be safely used if needed as long as the
dose is adjusted for your body’s level of kidney function.

3. Dietary
supplements

Certain herbs or nutritional
supplements are associated with kidney injury, even among healthy people. With
such a wide variety of supplements available, the best way to know if a
supplement is safe is to ask your doctor to review all the ingredients.

Dietary supplements aren’t
regulated by the Food and Drug Administration. Their manufacturers don’t have
to prove that they are safe to use, and ingredients can vary from one brand to
the next.

Researchers have reviewed 17 dietary supplements that have been associated with direct kidney injury, though in a very limited numbers of cases.

Of note, researchers found
that patients often don’t tell their doctors about the dietary supplements they
are taking. Doing this could put you at risk for injury and drug interactions.

If you already have
diminished kidney function or are at risk for kidney disease, it’s best not to
take dietary supplements or vitamin doses above the Recommended Daily Allowance
(RDA).

Are
you at risk for kidney disease?

Most people with kidney
disease don’t have any symptoms until they’re very sick. So unless your doctor
has tested your kidney function, you can’t be sure that you don’t have kidney
problems.

A few simple tests will tell
your doctor how well your kidneys are working. He or she will:

  • Check your blood pressure.
  • Take a blood sample and test the levels of blood urea nitrogen (BUN) and creatinine, which are indicators of how well your kidneys are cleaning your blood.
  • Take a urine sample to check for blood, infection or protein in your urine.

Even slightly higher than
normal blood pressure or cholesterol increases your risk for kidney disease,
stresses Dr. Heyka. So keep your blood pressure, cholesterol and weight in
check, as well as your blood sugar if you have diabetes. And, as always, make
sure you tell your doctor about every vitamin, herbal remedy and nutritional
supplement you take.

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