Seven Medicines Causing Your Kidney Damage

Antibiotics, while effective in treating infections, can pose risks to kidney health. Common antibiotics, such as Ciprofloxacin (Cipro), Amoxicillin (Augmentin), and others, are used to treat bacterial infections like strep throat, pneumonia, and urinary tract infections. However, antibiotics are ineffective against viral infections like colds and flu, and their improper use can cause side effects, including diarrhea and liver and kidney problems. Even when used correctly, some antibiotics, such as polymyxins and aminoglycosides, can harm the kidneys by damaging cell membranes or accumulating in kidney cells, leading to cell death and tubule damage. Proper use of antibiotics is essential, as nearly one-third of antibiotics prescribed in the U.S. are inappropriate for the conditions being treated.

NSAIDs, including ibuprofen, aspirin, and naproxen, are commonly used to relieve pain and inflammation. However, these drugs can harm the kidneys by blocking the enzyme cyclooxygenase (COX), which helps protect the kidneys and regulate sodium and water excretion. Blocking COX can reduce blood flow to the kidneys, leading to fluid retention, high blood pressure, and acute kidney injury (AKI). Prolonged NSAID use can trigger inflammation in the kidney tubules and lead to chronic kidney disease (CKD). Studies have shown that NSAID use increases the risk of AKI, particularly within the first 30 days of use, highlighting the need for caution with these medications.

Diuretics help manage fluid retention in conditions like heart and kidney failure. Common diuretics include hydrochlorothiazide, furosemide, and spironolactone. While diuretics generally benefit kidney health by lowering blood pressure, excessive use can lead to dehydration, a risk factor for kidney damage. A study found that patients on diuretics had higher rates of kidney disease and its risk factors, such as hypertension and diabetes. Proper hydration and regular monitoring of electrolytes and kidney function are crucial for people taking diuretics.

Proton Pump Inhibitors (PPIs)

PPIs, used to treat acid reflux and gastroesophageal reflux disease (GERD), reduce stomach acid production. Although PPIs are generally safe, they can cause acute interstitial nephritis (AIN), an inflammation of the kidney tubules. Long-term PPI use can lead to decreased kidney function and acute kidney injury, potentially progressing to CKD. Regular checkups to monitor kidney function and magnesium levels are recommended for people taking PPIs.

ACE Inhibitors

ACE inhibitors, such as lisinopril and enalapril, are used to lower blood pressure and manage heart and kidney conditions. While they improve blood flow to the kidneys and provide long-term protection, ACE inhibitors can increase the risk of AKI, particularly when combined with NSAIDs and diuretics. They can also cause a decline in the estimated glomerular filtration rate (eGFR) due to reduced pressure on the kidneys. Regular monitoring and dosage adjustments may be necessary for patients with heart failure, CKD, or other conditions.

Antiviral drugs, used to treat serious or long-lasting viral infections like COVID-19, HIV, and hepatitis, can harm the kidneys through direct toxicity or crystal buildup. Drugs like remdesivir, used for COVID-19, have been linked to decreased kidney function and acute kidney failure. Other antivirals, such as acyclovir and foscarnet, can cause acute tubular necrosis and crystal-induced kidney obstruction. Close medical supervision and proper dosage are essential for minimizing the risks.

Lithium, used to treat mood disorders like bipolar disorder, can negatively affect the kidneys with long-term use, leading to conditions such as nephrogenic diabetes insipidus and, in rare cases, end-stage renal disease (ESRD). Symptoms of kidney trouble from lithium include excessive urine output, constant thirst, and dehydration. Regular monitoring of kidney function and blood tests for creatinine levels are crucial for patients taking lithium.