Kidneys filter toxins, waste, and fluids from the blood, but injury or damage can impair their function. Health conditions like diabetes and high blood pressure, along with certain medications, can cause kidney damage.
These drugs are called nephrotoxic medications, which can range from mildly affecting kidney function to causing severe harm, with individual health conditions and specific drugs influencing the risk. Here are 10 medications associated with kidney damage.
Mask-clad patients, suffering from kidney failure, receive dialysis treatment at al-Thawra hospital in Yemen's third city of Taez, on June 8, 2020. Yemen is facing what the United Nations calls the world's worst humanitarian crisis.
Aminoglycoside Antibiotics
Administered via IV, these antibiotics can cause kidney injury, especially in individuals with chronic kidney disease, dehydration, or extended treatment duration beyond 10 days. These medications are mainly used in hospitals, allowing for close monitoring and potential dose adjustments based on a patient's medical history.
Angiotensin-Converting Enzyme (ACE) Inhibitors
ACE inhibitors, often used for managing high blood pressure and heart failure, have the dual potential of safeguarding the kidneys under certain circumstances and posing a kidney injury risk when co-administered with other nephrotoxic drugs or in dehydrated individuals. It is recommended to commence with lower doses and undergo frequent kidney health assessments via blood tests.
Calcineurin Inhibitors
Immunosuppressant medications, such as cyclosporine modified (Neoral) and tacrolimus (Prograf), commonly prescribed after organ transplants, carry a potential risk of kidney damage, which is more pronounced with higher doses and in individuals already vulnerable to kidney issues, necessitating kidney monitoring.
Contrast Dyes
Contrast dyes, such as iodinated radiocontrast agents, enhance organ and blood vessel visibility in radiographic tests but carry the risk of kidney injury, which tends to appear within 24 to 48 hours after contrast administration. Those with preexisting chronic kidney disease, diabetes, low blood volume, or taking other nephrotoxic medications are at higher risk, leading to adjustments in contrast dosage for at-risk individuals.
Diuretics
Diuretics, used for conditions like high blood pressure and heart failure, include popular options such as Hydrochlorothiazide and Furosemide. While generally well-tolerated, diuretics carry a risk of acute kidney injury, more prominent with higher doses, primarily affecting older adults by lowering blood volume and disrupting the filtration process.
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HIV Medications
Certain HIV medications, including tenofovir disoproxil fumarate and atazanavir, have been associated with the risk of kidney damage, particularly acute kidney injury in certain cases.
Before taking these medications, individuals should undergo kidney screening. If kidney problems are present, a lower dose may be necessary for safety, although not all HIV medications carry this risk, with newer formulations like tenofovir alafenamide being less likely to cause kidney toxicity.
Antiviral Medications
Acyclovir, ganciclovir, and other antiviral medications can induce kidney injury by producing undissolvable crystals that may lead to blockages in the filtration system, a risk exacerbated by dehydration or pre-existing kidney disease.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs, such as ibuprofen and naproxen, widely employed for pain and inflammation relief, can pose kidney risks, particularly for individuals with heart failure, liver disease, or pre-existing kidney conditions, underscoring the need for cautious, low-dose, and short-term utilization.
Vancomycin
Vancomycin, an antibiotic used for severe MRSA infections, can lead to kidney damage within 4 to 17 days of treatment, typically in hospital settings, with close monitoring and dose adjustments.
Zoledronic Acid
The bisphosphonate medication zoledronic acid, used for osteoporosis, and its counterpart Zometa for high calcium levels in cancer, carry a rare but serious risk of kidney damage, particularly for those with abnormal kidney function or pre-existing kidney damage, leading to an FDA warning.
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