Neph­ro­lo­gists flag indis­crim­in­ate use of paink­illers

Neph­ro­lo­gists are see­ing patients with kid­ney dys­func­tion who have a his­tory of fre­quent or unsu­per­vised use of paink­illers, with doc­tors warn­ing that repeated use of com­monly avail­able medi­cines can cause acute kid­ney injury and, in some cases, con­trib­ute to long-term kid­ney dam­age.
The obser­va­tions come after the Cent­ral Drugs Stand­ard Con­trol Organ­isa­tion (CDSCO) issued an advis­ory on Septem­ber 22 cau­tion­ing against the indis­crim­in­ate use of non­s­ter­oidal anti-inflam­mat­ory drugs (NSAIDs) and anti­bi­ot­ics and high­light­ing the asso­ci­ated risk of chronic kid­ney dis­ease.
KIDNEY DAMAGE
Accord­ing to Sandeep Mahajan, pro­fessor, Neph­ro­logy depart­ment at AIIMS Delhi, paink­iller use could have a primary or sec­ond­ary asso­ci­ation with kid­ney dis­ease in around 10-15 per cent of patients he sees.
He described a primary asso­ci­ation as the drug itself caus­ing dam­age and a sec­ond­ary asso­ci­ation as the medi­cine worsen­ing dam­age caused by another con­di­tion.
“Long-term chronic use of paink­illers can lead on to sig­ni­fic­ant kid­ney dam­age,” Mahajan said, refer­ring to the con­di­tion as anal­gesic neph­ro­pathy.
Doc­tors said the risk is par­tic­u­larly rel­ev­ant because many patients con­sider com­monly avail­able paink­illers to be harm­less.
Accord­ing to Sou­beer Ghosh, Con­sult­ant Neph­ro­lo­gist and Kid­ney Trans­plant Phys­i­cian, PSRI Hos­pital, New Delhi, NSAIDs such as ibupro­fen, diclofenac and naproxen can a–ect kid­ney func­tion when taken fre­quently, at high doses or without med­ical super­vi­sion.
They can reduce blood flow to the kid­neys, mak­ing it harder for them to fil­ter waste e–ect­ively.
SELF-MEDICATION
He said the more wor­ry­ing trend in clin­ical prac­tice was self-med­ic­a­tion, with some patients repeat­ing an old pre­scrip­tion whenever sim­ilar symp­toms recurred, without check­ing whether the medi­cine remains appro­pri­ate or whether their kid­ney func­tion has changed.
The doc­tors said older adults and people with preex­ist­ing kid­ney dis­ease, dia­betes, hyper­ten­sion, heart fail­ure or dehyd­ra­tion are par­tic­u­larly vul­ner­able to kid­ney-related com­plic­a­tions.
The neph­ro­lo­gists said the CDSCO advis­ory is an import­ant step, but its impact will depend on imple­ment­a­tion and aware­ness among patients, doc­tors and phar­macists.
“Pub­lic aware­ness is also very import­ant,” Mahajan said, adding that the advis­ory could help make inform­a­tion about the risks more widely avail­able.
Source: Pressreader