This is an automatically translated article.
Article by Doctor Duong Thanh Hai - Faculty of Pharmacy - Vinmec Times City International General Hospital.
When pain requires medication, patients can usually buy pain relievers at pharmacies such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). These medications are usually very effective at reducing pain and inflammation quickly, but if you have kidney failure, the use of pain relievers can potentially pose serious health risks because some pain relievers reduce blood supply. kidneys and cause more severe kidney damage.
Due to impaired kidney function, some drugs can also accumulate in the body and cause toxicity to the patient. However, this problem is often proactively preventable.
1. What is chronic kidney disease?
Chronic kidney disease, also known as chronic kidney failure, is a term describing a disease with a gradual loss of kidney function, the kidneys gradually decrease and lose the ability to remove toxins and excess fluid from the blood to eliminate waste. through urine. The cause of chronic kidney disease is often due to the progression of diseases such as diabetes, hypertension, glomerulonephritis, polycystic kidney disease, prolonged urinary tract obstruction, recurrent kidney infections ...
2. What drugs are used to relieve pain?
Analgesics are drugs used to control pain, some of which have both anti-inflammatory and antipyretic effects. Mild and moderate pain relievers can usually be purchased at pharmacies without a prescription, such as paracetamol (Panadol), NSAIDs: ibuprofen (Gofen), diclofenac (Voltaren), celecoxib ( Celebrex)... Drugs with strong analgesic effects of the opioid group such as morphine, fentanyl, oxycodone... require a prescription from an authorized physician.
Thuốc paracetamol là một loại thuốc giảm đau trong điều trị bệnh thận mạn
3. How can painkillers cause kidney damage?
Approximately 1–5% of people taking nonsteroidal anti-inflammatory drugs (NSAIDs) including high-dose aspirin may experience nephrotoxicity. The reason is that this group of drugs causes decreased perfusion to the kidney leading to impaired glomerular filtration function. The risk of kidney damage is markedly higher in people who already have chronic kidney disease. Acute kidney failure can occur in people with chronic kidney disease, especially if the patient is dehydrated (vomiting, diarrhea) or has low blood pressure.
4. What pain relievers are safe for people with chronic kidney disease?
Choosing the most optimal pain reliever depends on the individual patient's condition, no single drug can be considered the safest choice for all. Among the over-the-counter drugs, paracetamol is often the first-line pain reliever for most people with chronic kidney disease, however high doses of paracetamol can cause liver toxicity. Therefore, it is not recommended to take more than 4 g per day. Paracetamol has no anti-inflammatory effect, with painful inflammatory conditions, such as arthritis, the patient will need to be evaluated by a doctor to choose the right anti-inflammatory drug combination.
Sometimes NSAIDs will be prescribed but under close supervision, with dosage and duration of use depending on the patient's medical condition and kidney function. If you have moderate or severe pain, paracetamol may not be effective enough to control pain. In this case, the patient needs to use stronger opioid pain relievers such as tramadol, morphine... However, when using these drugs, the patient needs to be prescribed and selected by the doctor. in accordance with the degree of renal failure to avoid the risk of drug overdose.
Sử dụng thuốc paracetamol có thể khiến độc tố trên gan
5. Can people with chronic kidney disease take aspirin?
Aspirin belongs to the group of NSAIDs, widely used in the world at high doses with analgesic, anti-inflammatory and antipyretic effects. Currently, aspirin is mainly used for the secondary prevention of serious cardiovascular events such as myocardial infarction and ischemic stroke because of its antiplatelet effect that helps prevent thrombosis.For the prevention of cardiovascular events, aspirin is used at low doses (usually 81 to 162 mg per day) and should be maintained for a long time. People with chronic kidney disease who are at high risk for cardiovascular events may be prescribed low-dose aspirin by their doctor. In this case, the drug does not increase the risk of kidney damage and the patient needs to maintain the drug for a long time as prescribed by the doctor. However, for people with end-stage renal disease, aspirin use can increase the risk of bleeding, so the doctor will carefully evaluate and adjust the regimen accordingly for each patient.
Người bệnh thận mạn có thể dùng aspirin nhưng ở mức liều thấp
6. What should be done to protect the kidneys when taking painkillers?
Analgesic kidney disease is usually preventable when the patient follows the instructions of the healthcare professional, including:
Using the lowest effective dose of pain medicine for a short period of time Most Do not arbitrarily use over-the-counter pain relievers for more than 10 days. If the pain is not controlled, you should see a doctor. Avoid prolonged use of pain relievers that contain multiple ingredients, for example aspirin, paracetamol, codeine or tramadol combinations. Carefully read and fully check the ingredients of the drug on the product information label. Drink enough water while taking painkillers, do not drink alcohol while taking the medicine If you have kidney disease, you should consult your doctor before taking pain relievers, especially NSAIDs.
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