8 Drugs That Can Cause Kidney Damage

Your Kidneys and Medications: What You Need to Know

Your Kidneys: Important Functions and Risks

Your kidneys may be small in size, but they play an important role in the body. Kidneys remove waste, extra fluid, and acids, maintaining a balance of water, salts, and minerals in the blood. They also regulate blood pressure, help make red blood cells, and are involved with keeping your bones healthy.

Nephrotoxic Drugs: What You Need to Know

Some drugs are known as nephrotoxic, which means that their effects can cause damage to the kidneys. Drugs such as certain antibiotics, the mood stabilizer lithium, and nonsteroidal anti-inflammatory drugs (NSAIDs) can potentially harm the kidneys, especially under specific conditions.

ACE Inhibitors and ARBs

Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are classes of drugs commonly prescribed for blood pressure and heart conditions. Some information about them is:

• ACE inhibitors end in the letters "pril"; examples include Zestril (lisinopril) and Altace (ramipril).
• ARBs end in the letters "sartan"; examples include Diovan (losartan) and Benicar (olmesartan).

Diuretics

Diuretics, also known as "water pills," are prescribed to treat congestive heart failure, high blood pressure (hypertension), and edema (fluid retention). Diuretics can cause decreased blood flow to the kidneys, affecting their ability to filter blood properly. This can lead to a lack of oxygen and ultimately cause damage to the kidneys.

Certain Antibiotics

Antibiotics treat certain types of bacterial infections. Antibiotics are also one of the most common causes of drug-induced kidney damage. They can harm the tiny filtering units in the kidneys (glomeruli), hurt the kidney tubes that process waste, or clog the tubes with debris, which can prevent them from working properly.

How Drugs Can Cause Kidney Damage

Most drugs that can harm the kidneys do so in a few common ways. For example, they may:

• Change how blood flows through the kidneys
• Directly damage kidney cells
• Cause inflammation
• Block the kidney’s filters with crystals
• Break down muscle tissue (which then clogs the kidneys)
• Lead to tiny blood clots that affect kidney function

Protecting Your Kidneys from Medication Damage

You should always ensure that your healthcare provider knows about all of your medical conditions, your medical and family histories, the allergies you have, and the medications you take. Tell your provider about all the medications you take, including prescription and OTC drugs, vitamins, and supplements.

You can help protect your kidneys against drug-induced damage by:

• Filling all of your prescriptions at one pharmacy or within one chain so the pharmacist can see all of the medications you take and monitor for potential problems.
• Keeping an up-to-date list of your medications and bringing it to all your appointments.
• Dehydration can increase the risk of kidney problems, so talk to your healthcare provider about what to do if you have symptoms of an illness that can lead to dehydration, such as a fever, vomiting, or diarrhea.

When to Contact a Healthcare Provider

Sometimes, kidney problems do not produce any symptoms. For this reason, it’s crucial to keep all appointments with your healthcare provider for follow-up and monitoring.

The following symptoms can be signs of serious kidney complications:

• Back or flank pain (pain on the side, below the ribs)
• Blood in the urine
• Chest pain
• Confusion
• Fatigue and tiredness
• Fever or chills
• Low appetite
• Nausea
• Swelling in the lower legs and/or feet
• Trouble breathing, such as shortness of breath
• Urinary problems, such as pain during urination, difficulty urinating, urinating less or not at all, or feeling a constant urge to urinate
• Urine that is not the usual color

Summary

The kidneys have many important functions to keep the body working properly. Certain drugs are nephrotoxic, which means they can cause harm to your kidneys. There are many medications that can harm the kidneys. Some of these are ACE inhibitors and ARBs, diuretics, antibiotics, PPIs, NSAIDs, lithium, HIV drugs, and calcineurin inhibitors. Always consult a healthcare provider for information and medical advice about your kidney health and the medications—both prescription and OTC—vitamins, and supplements you take.