Pain Meds and CKD?

[KarenInWA]

I currently have about 30% kidney function.  My 65-yo-father has much better kidney function than me, and also sees the same neph I do.  When he told the neph that he had taken ibuprofen for a gout attack, our neph warned him to not take *any* pain meds at all, including acetaminophen (Tylenol) and anything that may be prescribed after a surgery.  Now, I understand that I shouldn't take NSAID's (ibuprofen, Aleve, etc) but what's wrong with the occassional Tylenol for a headache, or needed pain meds after a surgery?  As long as it's not taken all the time, I don't see what the big deal is?  Is my neph just a bit too careful about this, or are we kidney patients really just supposed to suck it up and live through the pain?  Don't we have to go through enough?  Any insight will be much appreciated.  Thank you!

KarenInWA

[nursewratchet]

He is probably just overcautious.  All of our patients take pain meds if they need them.  The Tylenol should always be fine if you don't exceed the max dose (4 grams\day).  That is very toxic to liver.  The NSAIDS are toxic to kidneys, but our Dr.s tell the patients to be very moderate, after all, the hemo patients anyway, already have a useless kidney.  No one should be made to suck it up for pain. 

[boxman55]

My nepth told me to take naproxin (aleve) for my gout pain. I don't think it matters if you have no kidney function...Boxman

[KarenInWA]

My nepth told me to take naproxin (aleve) for my gout pain. I don't think it matters if you have no kidney function...Boxman

But, how about for those of us who still do have kidney function?  I am currently at or around 30%.  Is Tylenol and other pain meds (not NSAID's) dangerous for those of us who still have some, but not enough, kidney function?  I rarely take them, but I'm certainly not going to NOT take them when I have a headache, and I most certainly will take them after a surgery.  To not take them would be cruel and unusual punishment!

[pelagia]

From the National Kidney Foundation:

Many analgesic medicines (pain relievers) are available over the counter. These medicines are generally safe when taken as directed. However, their heavy or long-term use may harm the kidneys. Up to an estimated three to five percent of the new cases of chronic kidney failure each year may be caused by chronic overuse of these medicines. It is important to realize that, while helpful, these medicines are not completely without risk, and they should be used carefully. Kidney disease related to analgesics is preventable.

What are analgesics?

Analgesics are medicines that help to control pain and reduce fever. Examples of analgesics that are available over the counter are: aspirin, acetaminophen, ibuprofen, ketoprofen and naproxen sodium. Some analgesics contain a combination of ingredients in one pill, such as aspirin, acetaminophen and caffeine.

Can analgesics hurt kidneys?

Generally, when used according to directions, over-the-counter analgesics are safe. However, heavy or long-term use of these medicines, especially those that contain a mixture of painkilling ingredients--such as aspirin, acetaminophen and caffeine--in one pill, have been linked to chronic kidney disease in European studies. The warning labels on over-the-counter analgesics tell you not to use these medicines more than 10 days for pain and more than three days for fever. If you have pain and/or fever for a longer time, you should see your doctor. The doctor can check for possible medical problems and advise you about what medications you should take.

Is aspirin safe for regular use?

When taken as directed, regular use of aspirin does not seem to increase the risk of kidney disease in people who have normal kidney function. However, taking doses that are too large (usually more than six or eight tablets a day) may temporarily reduce kidney function. In people with kidney disease, aspirin may increase the tendency to bleed. People who already have reduced kidney function, or other health problems such as liver disease or severe heart failure, should not use aspirin without speaking to their doctor.

My doctor recommended that I take an aspirin every day to prevent heart attacks. Will this hurt my kidneys?

No. There is no risk to the regular use of aspirin in the small doses recommended for prevention of heart attacks.

What analgesics are safe for people who have kidney disease?

Acetaminophen remains the drug of choice for occasional use in patients with kidney disease because of bleeding complications that may occur when these patients use aspirin. However, kidney patients who need to use acetaminophen habitually should be supervised by their doctors.

What are NSAIDs? Are they safe to take?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a specific group of pain relievers. Some NSAIDs are available over the counter. This includes different brands of ibuprofen, naproxen sodium and ketoprofen.

NSAIDs are safe for occasional use when taken as directed. However, these medications should only be used under a doctor's care by patients with kidney disease, heart disease, high blood pressure or liver disease or by people who are over 65 or who take diuretic medications. In these people, NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage.

http://www.kidney.org/ATOZ/atozItem.cfm?id=23

[KarenInWA]

Thank you for that info, Pelagia!  It confirmed what I thought.  i don't take pain meds very often.  In fact, I usually lose the bottle and have to buy a new one!  My med of choice is acetaminophen, and I usually only have to take one dose and I'm fine.  Even when I've had surgeries, I've ended up taking pain meds for less than 24 hours.  I just don't want my neph jumping on me over something that isn't that big a deal.  Thank you for putting my mind at ease!

[BRANDY]

Im reading about all these medicines , my doc says do not take them I have lots of pain from car wreck  thats another story) but I take darvocet  and did take Tramidol  . Eitherone will help you with pain  They also will make you drowsey ,that isnt good. tho.  Just my 2 cents worth

[Sunny]

I am only allowed Tylenol or vicodin.