Unless you’ve had problems in the past, you probably take for granted that your kidneys are working as they should. But one in five men and one in four women in the United States are estimated to have chronic kidney disease, and most people who have it don’t know it. Even more alarmingly, over-the-counter medicines, common prescriptions, and nutritional supplements can have serious effects on kidney function. You are at higher risk if your kidneys aren’t completely healthy to begin with, says Robert Heyka, MD, Chair of Cleveland Clinic’s Department of Nephrology & Hypertension. Only your doctor can perform the tests to determine whether your kidneys are healthy. However, there are certain health problems that make a person more likely to develop kidney disease. If you have one of these health conditions, or if you or your family has a history of kidney problems, it’s important to have your kidneys checked once a year: But even if you don’t have any risk factors, a yearly check-up with blood pressure check, lab and urine tests is the only way to get a clear picture of your kidney function, says Dr. Heyka.
RELATED: Chronic Kidney Disease Treatment Guide The following drugs and supplements can affect kidney function: 1. NSAIDS (Non-steroidal anti-inflammatory drugs) NSAIDs are very effective medications for multiple medical problems. But taking NSAIDS can affect the kidneys, and can cause damage, especially if you’re also taking diuretics (“water pills”) or ACE inhibitors. NSAIDS include over-the-counter painkillers like aspirin (Ascriptin®, Bayer® and Ecotrin®), ibuprofen (Advil®, and Motrin®), and naproxen (Aleve®). They also include prescription drugs like: Use of these medications with caffeine can further harm your kidneys. When taking these medications, be sure to check regularly with your doctor if you have impaired kidney function. RELATED: How to Avoid Surprising Risks of OTC Medications Certain antibiotics are removed from the body through the kidneys, so taking them can put extra strain on your kidneys. Penicillin, cephalosporins and sulfonamides in particular can be harmful to your kidneys.
Long-term antibiotic use can injure your kidneys, even if you’re otherwise healthy. And for people whose kidneys aren’t functioning at 100 percent to begin with, antibiotics can build up in the body and cause damage. Despite this, it’s important to keep in mind that antibiotics can be safely used if needed as long as the dose is adjusted for your body’s level of kidney function. Certain herbs or nutritional supplements are associated with kidney injury, even among healthy people. With such a wide variety of supplements available, the best way to know if a supplement is safe is to ask your doctor to review all the ingredients. Dietary supplements aren’t regulated by the Food and Drug Administration. Their manufacturers don’t have to prove that they are safe to use, and ingredients can vary from one brand to the next. A recent review lists 17 dietary supplements that have been associated with direct kidney injury, though in a very limited numbers of cases.
Of note, researchers found that patients often do not tell their doctors about the dietary supplements they are taking. Doing this could put you at risk for injury and drug interactions. If you already have diminished kidney function or are at risk for kidney disease, it is best not to take dietary supplements or vitamin doses above the Recommended Daily Allowance (RDA). RELATED: 7 Secrets to Keeping Your Kidneys Happy Most people with kidney disease don’t have any symptoms until they’re very sick. So unless your doctor has tested your kidney function, you can’t be sure that you do not have kidney problems. A few simple tests will tell your doctor how well your kidneys are working. He or she will: Even slightly higher than normal blood pressure or cholesterol increases your risk for kidney disease, stresses Dr. Heyka. So keep your blood pressure, cholesterol, and weight in check, as well as your blood sugar if you have diabetes. And, as always, make sure you tell your doctor about every vitamin, herbal remedy, and nutritional supplement you take.
Vitamin D compounds for people with chronic kidney disease requiring dialysis We confirm that vitamin D compounds suppress PTH in people with CKD and requiring dialysis although treatment is associated with clinical elevations in serum phosphorus and calcium. All studies were inadequately powered to assess the effect of vitamin D on clinical outcomes and until such studies are conducted the relative importance of changes in serum PTH, phosphorus and calcium resulting from vitamin D therapy remain unknown. Observational data showing vitamin D compounds may be associated with improved survival in CKD need to be confirmed or refuted in specifically designed RCTs. Clinical guidelines recommend vitamin D compounds to suppress serum parathyroid hormone (PTH) in chronic kidney disease (CKD), however treatment may be associated with increased serum phosphorus and calcium, which are associated with increased mortality in observational studies. Observational data also indicate vitamin D therapy may be independently associated with reduced mortality in CKD.
We assessed the effects of vitamin D compounds on clinical, biochemical, and bone outcomes in people with CKD and receiving dialysis. Randomised controlled trials (RCTs) in subjects with CKD and requiring dialysis that assessed treatment with vitamin D compounds. Data was extracted by two authors. Results are summarised as risk ratios (RR) for dichotomous outcomes or mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI). Sixty studies (2773 patients) were included. No formulation, route, or schedule of administration was associated with altered risks of death, bone pain, or parathyroidectomy. Marked heterogeneity in reporting of outcomes resulted in few data available for formal meta-analysis. Compared with placebo, vitamin D compounds lowered serum PTH at the expense of increasing serum phosphorus. Trends toward increased hypercalcaemia and serum calcium did not reach statistical significance but may be clinically relevant. Newer vitamin D compounds (paricalcitol, maxacalcitol, doxercalciferol) lowered PTH compared with placebo, with increased risks of hypercalcaemia, although inadequate data were available for serum phosphorus.