How Does Drug Abuse Affect Kidneys

Today painkillers have become a part and parcel of our everyday life. Be it a body pain, a headache or the pain of a wound, one pill can give us relief for some period of time! And we often tend to stay contented with this belief without making an attempt to know more about these magic pills other than their pain relieving feature. The National Institutes of Health (NIH) recently issued a report stating that combinations of antipyretic analgesics, taken in large doses over a prolonged period, cause a specific form of kidney disease and chronic renal failure. Also, taking painkillers for more than 10 years triples the risk of kidney disease and there are hundreds of people who are on kidney dialysis or received transplants or have died due to kidney damage or kidney failure from painkillers. Quite alarming- I must say. Some medications are nephrotoxic, which means that they have an elevated risk for harming the kidneys. In the worst case, the drug causes kidney failure while in other cases, the kidneys are damaged but may not fail.

Analgesics like nonsteroidal anti-inflammatory drugs (NSAID's), are one amongst the most common nephrotoxic drugs. They act in various ways on the peripheral and central nervous system by suppressing the action of prostaglandins (local hormones within the body). Prostaglandins play a major role in the transmission of pain information to the brain. They are produced by many body tissues and have a wide variety of local effects. Hence, blocking their production can cause an array of potential side-effects, including gastrointestinal bleeding, visual disturbances, liver abnormalities, high blood pressure and variety of kidney disturbances. The severity of renal side-effcets range from mild, reversible changes in water metabolism to permanent kidney failure. NSAID's are known to cause pronounced declines in the renal function within hours in the stressed kidney by reducing the renal plasma flow & glomerular filtration rate (eGFR). Furthermore, prolonged use of NSAID's increase the risk of permanent renal damage in patients with already impaired renal function. Analgesic use has been associated with two different forms of kidney damage: acute renal failure and a type of chronic kidney disease called analgesic nephropathy.

Acute Renal Failure - Consumption of OTC painkillers causes some people to experience acute illnesses involving fluid loss or decreased fluid intake. These cases involved intake of single dose in some instances and generally short-term analgesic use of not more than 10 days. Acute kidney failure requires emergency dialysis to clean the blood. Kidney damage is frequently reversible, with the kidney functioning normally as soon as the analgesic use is stopped.

Analgesic Nephropathy - This is a disease resulting from the habitual consumption over several years of a mixture containing at least two antipyretic analgesics, usually codeine or caffeine. It is characterized by renal papillary necrosis and chronic interstitial nephritis that leads to the insiduous onset of progessive renal failure. People who take OTC painkillers regularly should check with their primary care physician to make sure the drugs are not hurting their kidneys. The physician may be able to recommend a safer alternative and can order regular tests to monitor their kidney function.

Renal Papillary Necrosis - Renal papillary necrosis is seen with analgesic nephropathy. It is a disorder of the kidneys in which all or a part of renal papillae die. The renal papillae is the area where the openings of the collecting ducts enter the kidney and the cells in this region become necrotic and start to die off.

Renal function tests - Kidney function tests are the common Pathology Test used to evaluate how well the kidneys are working. People who develop chronic kidney disease may go for some or all of the following tests and measurements.

Serum Creatinine - Kidney function test is a waste product in the blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function slows down, the creatinine level rises. The doctor should use the results of serum creatinine test to calculate Kidney function tests.

Glomerular Filtration Rate (GFR) - It is the best test to measure the level of kidney function and determine the stage of kidney disease. It may be estimated from the blood level of creatinine.

Blood Urea Nitrogen (BUN) - Kidney function tests is anormal waste product in your blood that comes from the breakdown of protein from the food consumed and from body metabolism. It is normally removed from your blood by the kidneys, so when kidney function slows down, the Kidney function tests level rises. However, BUN can also rise if a person eats more protein, and can fall if less protein is consumed.

Urine Protein When kidneys are damaged, protein leaks into the urine. A simple test can be done to detect protein in urine. Persistent protein in the urine is an early sign of chronic kidney disease.

Microalbuminuria - Most proteins are to large to pass through the glomeruli into the urine. But when the glomeruli are damaged, proteins of various sizes pass through them and are excreted in the urine. Albumin is a relatively small molecule, so it is often amongst the first protein to enter the urine due to kidney damage.

Urine Creatinine - Creatinine is a breakdown product of creatine and is removed from the body entirely by the kidneys. So, the urine creatinine is usually used as screening test to evaluate kidney function. Abnormal results of urine creatinine may indicate conditions like glomerulonephritis, kidney infection or kidney failure. However, OTC painkillers present no danger for most people when taken in the recommended dosage but as said too much of anything is poison and same is with medicines. If one becomes addicted to these pills it is a case where the cure becomes a disease. So think twice before popping those painkillers, but if you are suffering from chronic pain and use painkillers on a regular basis, you should look for other ways to alleviate it. So check with your physician for the safest way to keep your pain under control and avoid serious side effects happening from painkillers.