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 While some previous research has linked NSAIDs to impaired kidney
function, the results have been mixed and often overlooked the
effects on people with high blood pressure, or hypertension, which
itself carries an elevated risk for kidney damage.
For the current study, researchers examined data on more than 30,000
people with hypertension and found that those who'd been taking
NSAIDs for at least three months were 32 percent more likely to have
chronic kidney disease than participants who didn’t use the pills.
In addition, participants who typically took NSAIDs more than once a
day had a 23 percent greater risk of developing chronic kidney
disease than people who didn’t use the pills.
Even if patients used NSAIDs for less than three months, they still
had an 18 percent higher risk of developing chronic kidney disease,
the study found.
“Our results suggest that NSAID duration plays a role in chronic
kidney disease among subjects with hypertension,” said senior study
author Hui-Ju Tsai, a scientist at the Institute of Population
Health Sciences, National Health Research Institutes in Zhunan.
“Physicians should exercise caution when administering NSAIDs to
people with hypertension and closely monitor renal function,” Tsai
said by email.
NSAIDs are among the most commonly used pills in the world for
ailments ranging from headaches to fever, arthritis and menstrual
cramps. This family of medicines includes over-the-counter drugs
such as aspirin, which can also help prevent strokes and heart
attacks, as well as ibuprofen (Motrin, Advil) and naproxen (Aleve).
Prescription NSAIDs include naproxen (Naprosyn) and celecoxib (Celebrex).
About one in three adults have high blood pressure, an often silent
condition that can damage the heart and blood vessels and lead to
stroke, kidney failure and other problems, according to the U.S.
National Institutes of Health.
Renal damage can develop in people with hypertension because the
kidneys are laced with dense blood vessels transporting high volumes
of blood. Uncontrolled hypertension can make arteries around the
kidneys harden, weaken or narrow, damaging the organs by restricting
blood flow.
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One shortcoming of the study is a lack of blood test data to confirm
the severity of kidney disease, the authors note in the journal
Hypertension. It’s also possible that some patients with kidney
disease weren’t identified due to a lack of clinical or laboratory
data.
In addition, the study only tracked prescription NSAID use. In
Taiwan, the vast majority of people taking these drugs get
prescriptions because the cost is much lower than it would be for
over-the-counter versions of the drugs, the authors point out.
While past research has suggested that kidney damage linked to
NSAIDs might be reversed once the pills are stopped, the current
study points to the possibility that long-term use of these
painkillers might lead to permanently impaired renal function, said
Dr. Liffert Vogt, a nephrologist at Academic Medical Center at the
University of Amsterdam in The Netherlands.
NSAIDs can cause the kidney to retain salts and water, prompting a
rise in blood pressure and potentially making medications to lower
hypertension ineffective, Vogt, who wasn’t involved in the study,
said by email.
“When a patient is already treated with a blood pressure lowering
drug, NSAIDs should be avoided,” Vogt said. “The negative effects of
NSAIDs on the kidneys can be explained by their effects on blood
pressure control.”
SOURCE: http://bit.ly/1CSGNqI Hypertension, online July 13, 2015.
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